Pacientų teisės pasirinkti pirminės sveikatos priežiūros įstaigą vertinimas konkurencijos sąlygomis

Management of Public Health The assessment of patients right to choose primary health care institution in the context of competition Simona Stulpinaitytė Supervisor Prof., dr. Irayda Jakušovaitė Department of Social Medicine, Faculty of Public Health, Kaunas University of Medicine. Kaunas; 2005. 65 p.

Aim of the study. To assess and compare patients possibility to use their right to choose primary health care institutions in the context of competition. Objectives. 1) To assess factors who determine the choice of private or public primary health care institution; 2) To compare patients opinion about services that are provided in public and private health care institutions; 3) To compare ethical problems in healh care in micro (doctor – pacient) level in public and private health care institutions. Methods. During the survey there were questioned 380 patients at the public and private health care institutions in Garliava. Response rate in public health care institutions was 81% and in private health care institution it was 84%. Statistical analysis was carried out using statistical package for social sciences - SPSS 11.5 for Windows. Associations between the variables were tested by Chi squared. Patients answers under provided services in public and private health care institutions were analyzed by measuring means that were compared using the Stujdent test (t). Significance level (p) less than 0,05 was considered as statistically significant (p<0,05). Results. The most important factors that determined the choice of public health care institutions were attendance of this institution for whole life (44,7%) and that the institution was near their home (35,8 proc.). Private health care instititutions were chosen because patients simply had to access the doctor (17,4%) also because this institution was better than previous one (38,4%) and because it also was near their home (41,1%). The ticket at registry for the same day when patients have refered to institution was received by 84,7 % respondents in private institutions and by 50% in public health care institution. Possibility to access their doctor always in appointed time had 24,7% respondents in public institution and 63,2% in private institutions. There were 46,8% respondents in public sector and 67,9% in private sector who stated that they hade possibility to access their doctor any time. 63,2% respondents in public sector and 87,9% in private sector were always satisfied with services provided by their doctor. Almost all respondents in both sectors stated that they trusted medical personnel and that doctor always communicated with them politely. 21,6% questioned patients in public sector and 13,7% in private sector supposed that giving presents to doctors always assure better care of their health. Conclusions. Almost all respondents had possibility to choose primary health care institution easily. Major part of questioned patients in public and private health care institutions assessed health care services positively. Doctors communicated with patients politely in both - public and private primary health care institutions. But there was statisticaly significant difference that in public health care institution patients more often hade conflicts with their doctors.