Perceptions of Maltese patients of current healthcare provision : a preliminary study

Abstract

Aims and objectives: Patient perspectives are increasing in importance in healthcare, becoming incorporated in care delivery. This preliminary study assessed expectations and perceptions of public and private healthcare quality in a chronic disease clinic. Methods: A literature review focused on clinical quality improvement, and patient satisfaction. A Patient Perspective Profile was constructed, including the use of GAP analysis to identify gaps between expectations and perceptions of care, and perceptions of patient safety. Qualitative study; purposive sampling conducted from a chronic disease clinic. Structured interview groups assessed expectations and perceptions of healthcare quality and satisfaction in public/private sectors. Summary of results: Eighteen patients participated, the majority female; all age groups and educational levels were represented; with experience of public/private healthcare at primary/secondary levels. Patient satisfaction was high; dissatisfaction with waiting times between appointments, lack of timely access to outpatient care, and lack of chaperones. Areas for improvement included access to outpatient care, continuity of care and access to medication. Gap analysis revealed gaps for ‘Better Communication with providers’, ‘Better Communication between providers’, ‘Better professionalism by the provider’, and ‘reliability to perform accurately’. Responsiveness to patient needs, revealed performance surpassing expectation; no significant gaps in tangibility of the service, Empathy to pts and Service recovery. Government primary and secondary healthcare suffer from poorer perception. Patients considered both patient safety and effective communication to be most important aspects of practice; healthcare was incorrectly perceived to be very safe. Implications: Training needs to focus on gap areas, including communication. The reasons for differing satisfaction in different systems, in spite of care delivery by the same providers, needs to be addressed. Patient safety is not an issue.