Measuring community perception of Healthcare Delivery Systems: A Tool Developmental Process.

Author(s) Nur Ezdiani Mohamed1, Jabrullah Ab Hamid2, Samsiah Awang3, Farrah Ong Abdullah 4, Zurriyati Ya'kub 5, Low Lee Lan6, Lin Naing7
Affiliation(s) 1Health Care Quality Research Division, Institute fo Health Systems Research, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia, 2Health Care Services Research, Institute fo Health Systems Research, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia, 3Health Care Quality Research Division, Institute fo Health Systems Research, Ministry of Health Malaysia, Subang Jaya, Selangor, Malaysia, 4Health Outcome Research Division, Institute fo Health Systems Research, Ministry of Health Malaysia, Shah Alam, Selangor, Malaysia, 5Information Communication Technology Division, Institute fo Health Systems Research, Ministry of Health Malaysia, Rawang, Selangor, Malaysia, 6Health Care Services Research, Institute fo Health Systems Research, Ministry of Health Malaysia, Subang Jaya, Selangor, Malaysia, 7Institute of Medicine, University of Brunei Darussalam (UBS), Brunei-Muara, Brunei, Brunei.
Country - ies of focus Malaysia
Relevant to the conference tracks Social Determinants and Human Rights
Summary This study is to develop a tool to measure users' satisfaction on the healthcare delivery service.The tool (questionnaire) to measure patient satisfaction was adopted based on Health-seeking behaviour models by Susanna et al. (2003), with regard to this study context. Items were derived from the literature (published and grey), findings from the FGD (focus group discussion), in-depth interviews, and from expert-opinion.Exploratory factor analysis classified the items/domains into five.

The validated questionnaire can be used to measure perception towards healthcare system in the Malaysian context. It can be further tailored to needs.

Background There are quite a number of tools measuring users’ satisfaction on the healthcare delivery service, yet little is known on how to measure their perception as well as discriminating the factors pertinent in choosing their provider.
Objectives The study was carried out to develop a tool that can measure users' perception and satisfaction on the healthcare delivery services.
Methodology A triangulation of three different sources (published literature; qualitative feedback from community and panel experts; and reviews on local theses and administrative data) was used to identify factors related to health seeking behaviour as well as factors that concerned the users in evaluating a provider both in term of local context and from other regions. A self-administrated survey was done on 347 randomly selected adult individuals exited from out- and in-patient area in health facilities; both public and private.
Results Acceptable internal reliability consistency coefficients (Cronbach’s α) ranged from 0.78 to 0.91. As for the Perception section; The Principal Component Analyses (PCA) classified five domains, corresponding to: (1) clinical resources (4 items), (2) supportive resources (12 items), (3) opportunity to meet doctors (5 items), (4) during/after meeting the healthcare provider/doctor (10 items), and (5) treatment charge (1 item). For the Factors Influencing Decision Making it was short-listed to 17 items, alpha 0.89.
Conclusion The validated questionnaire demonstrated good psychometric properties. It can be used to measure perception on the health care delivery systems as well as distinguishing factors influencing the provider choice in Malaysian context. Further refinement is encouraged.

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