Latent Factors Influencing the Views of Residents of Small Towns and Villages on Healthcare System
DOI:
https://doi.org/10.14515/monitoring.2024.4.2449Keywords:
patient satisfaction, quality assessment of medical care, rural healthcare, views on healthcareAbstract
The article discusses the circumstances that form the semantic background for citizens’ rational judgments about the quality of medical care and the healthcare system in general. This topic may be interesting in the context of the broader issue of the factors influencing patient satisfaction and public opinion about health care, and it resonates with methodological discussions about the possibilities of measuring these opinions.
We used the data from an empirical study of the impact of COVID-19 pandemic on medical providers in small towns and rural areas of two regions of Russia (2022). Our analysis is based on semi-structured interviews and informal conversations with residents of settlements served by district and central district hospitals and their rural structural units (outpatient clinics, feldsher stations). From the informants’ personal experiences of interaction with medical providers and the reasoning behind their reviews of local doctors we identified circumstances that may influence direct assessments of satisfaction and trust, usually measured in standardized surveys.
We focused on those factors that are difficult to identify and take into account in quantitative research, in contrast to the socio-demographic characteristics of respondents and the specifics of medical providers.
Among them are memorable personal experiences, knowledge about healthcare system, skills in the field of information and communication technologies, the perception of medical worker as a stranger or a native in local community, communications with health care professionals, the general attitude towards the state, and the attitude towards one’s own body and health. These findings confirm doubts about the reliability of using patient opinion measurements in management practice for assessing the state or dynamics of the healthcare system and developing public policy.
Acknowledgments. The authors thank the two HSE University expedition members who participated in the fieldwork and collected the materials used in this article.
References
Астафьев Л. М. Роль типологизации пациентов в оценке качества медицинской помощи // Социологические исследования. 2005. № 6. С. 136—140.
Astafyev L. M. (2005) The Role of Typologization of Patients in Assessing the Quality of Medical Care. Sociological Studies. No. 6. P. 136—140. (In Russ.)
Блинова Т.В., Вяльшина А.А., Русановский В.А. Отношение сельского населения к своему здоровью и доступности медицинской помощи // Экология человека. 2020. № 12. С. 52—58. https://www.doi.org/10.33396/1728-0869-2020-12-52-58.
Blinova T. V., Vyalshina A. A., Rusanovskiy V. A. (2020) Self-Perceived Health, Availability of Medical Care and Health Attitudes among Rural Population in Russia. Ekologiya cheloveka [Human Ecology]. 2020. No. 12. P. 52-58. https://www.doi.org/10.33396/1728-0869-2020-12-52-58. (In Russ.)
Богдан И.В., Гурылина М. В., Зверев А. Л., Чистякова Д. П. Политическое восприятие системы здравоохранения населением: опыт мониторинговых исследований // Вестник Томского государственного университета. Философия. Социология. Политология. 2020. № 55. С. 216—230.
Bogdan I.V., Gurina M. V., Zverev A. L., Chistyakova D. P. (2020) А Political Perception of the Healthcare System: An Experience of a Monitoring Research. Bulletin of Tomsk State university. Philosophy. Sociology. Political Science. No. 55. P. 216—230. (In Russ.)
Богдан И. В., Праведников А. В., Чистякова Д. П. Актуальные вызовы и решения для использования социологии в управлении здравоохранением // Здоровье мегаполиса. 2021. Т. 2. № 1. С. 79—83. https://doi.org/10.47619/2713-2617.zm.2021.v2i1;79-83.
Bogdan I. V., Pravednikov A. V., Chistyakova D. P. (2021) Current Challenges and Solutions for Use of Sociology in Healthcare Management. City Healthcare. Vol. 2. No. 1. P. 79—83. https://doi.org/10.47619/2713-2617.zm.2021.v2i1;79-83. (In Russ.)
Вялых Н.А., Беспалова А.А., Зарбалиев В.З. Доверие и недоверие российского общества к институту здравоохранения: социальные индикаторы и постпандемические эффекты // NOMOTHETIKA: Философия. Социология. Право. 2023. Т. 48. №. 3. С. 458—470. https://doi.org/10.52575/2712-746X-2023-48-3-458-470.
Vyalykh N.A., Bespalova A.A., Zarbaliev V.Z. (2023) Russian Society's Trust and Distrust to the Institution of Healthcare: Social Indicators and Post-pandemic Effects. NOMOTHETIKA: Philosophy. Sociology. Law. Vol. 48. No. 3. P. 458—470. https://doi.org/10.52575/2712-746X-2023-48-3-458-470. (In Russ.)
Гехт И. А., Артемьева Г. Б. К вопросу об изучении удовлетворенности населения системой здравоохранения // Менеджер здравоохранения. 2014. № 4. С. 6—12.
Geht I. A., Artemieva G.B. (2014) On the Question of Study on Public’s Satisfaction with Health Care System. Health Care Manager. No. 4. P. 6—12. (In Russ.)
Кобякова О. С., Деев И.А., Тюфилин Д.С., Куликов Е.С., Табакаев Н.А., Воробьева О.О. Удовлетворенность медицинской помощью: как измерить и сравнить? // Социальные аспекты здоровья населения. 2016. № 3. https://doi.org/10.21045/2071-5021-2016-49-3-5.
Kobyakova O.S., Deev I.A., Tyufilin D.S., Kulikov E.S., Tabakaev N.A., Vorobyeva O.O. (2016) Satisfaction with Health Care: How to Measure and Compare? Social Aspects of Population Health. No. 3. https://doi.org/10.21045/2071-5021-2016-49-3-5. (In Russ.)
Кочкина Н. Н., Красильникова М. Д., Шишкин С. В. Доступность и качество медицинской помощи в оценках населения. Препринт WP8/2015/03; Нац. исслед. ун-т «Высшая школа экономики». М.: Издательский дом Высшей школы экономики, 2015.
Kochkina N. N., Krasilnikova M. D., Shishkin S. V. (2015) Availability and Quality of Medical Care in Population Assessments. Preprint WP8/2015/03 (Series WP8 “State and Municipal Administration”); National Research University “Higher School of Economics”. Moscow: HSE Publishing House. (In Russ.)
Лопатина М.В. и др. Кросс-секционное исследование по оценке грамотности в вопросах здоровья населения старше 18 лет в отдельных регионах Российской Федерации: актуальность и дизайн // Экология человека. 2022. Т. 29. № 2. С. 89—98. https://doi.org/10.17816/humeco65198.
Lopatina M. V., Popovich M.V., Fomicheva M.L., Ziganshina Z.R., Prischepa N.N., Kontsevaya A.V., Drapkina O.M. (2022) Cross-Sectional Study to Measure Health Literacy among the Population over 18 Years Old in Selected Regions of the Russian Federation: Relevance and Study Design. Ekologiya cheloveka (Human Ecology). Vol. 29. No. 2. P. 89—98. https://doi.org/10.17816/humeco65198. (In Russ.)
Решетников А. В., Айвазян Ш. Г., Присяжная Н. В. Роль участкового врача во мнениях молодых и опытных профессионалов // Мониторинг общественного мнения: экономические и социальные перемены. 2020. № 2. С. 331—346. https://doi.org/10.14515/monitoring.2020.2.764.
Reshetnikov A. V., Aivazyan S. G., Prisyazhnaya N. V. (2020) Role of the District Physician in Shaping the Opinions of Young and Experienced Professionals. Monitoring of Public Opinion: Economic and Social Changes. No. 2. P. 331—346. (In Russ.)
Светличная Т. Г., Цыганова О. А., Борчанинова Е. Л. Пациенты о качестве стационарного обслуживания // Социологические исследования. 2010. № 7. С. 69—75.
Svetlitchnaya T. G., Tsyganova O. A., Borthcaninova E. L. (2010) Patients on the Medical Services Quality. Sociological Studies. No. 7. P. 69—75. (In Russ.)
Цыганков Б. Д., Малыгин Я. В. Подходы к изучению факторов, влияющих на удовлетворенность пациентов медицинской помощью (по данным иностранной литературы) // Проблемы социальной гигиены, здравоохранения и истории медицины. 2014. № 4. С. 18—22.
Tsygankov B. D., Malygin Ya. V. (2014) The Approaches to Investigation of Factors Impacting Satisfaction of Patients with Medical Care (According International Publications’’ Data). Problems of Social Hygiene, Health Care and the History of Medicine. No. 4. P. 18—22. (In Russ.)
Шилова Л. С. Оценка пациентами услуг первичной медицинской помощи (в Липецкой и Тюменской областях) // Журнал исследований социальной политики. 2008. Т. 6. № 3. С. 357—384. URL: https://jsps.hse.ru/article/view/3624 (дата обращения: 28.06.2023).
Shilova L. S. (2008) Evaluation of Primary Health Care by the Patients (In Lipetsk and Tumen Oblasts). Journal of Social Policy Studies. Vol. 6. No. 3. P. 357—384. URL: https://jsps.hse.ru/article/view/3624 (accessed: 28.06.2023). (In Russ.)
Шнайдер Г. В., Деев И. А., Кобякова О. С., Бойков В. А., Барановская С. В., Протасова Л. В., Шибалков И. П. Оценка удовлетворенности населения медицинской помощью // Социальные аспекты здоровья населения. 2020. № 4. С. 1—5. https://doi.org/10.21045/2071-5021-2020-66-4-4.
Shnaider G.V., Deev I.A., Kobyakova O.S., Boykov V.A., Baranovskaya S.V., Protasova L.M., Shibalkov I.P. (2020) Assessment of Public Satisfaction with Health Care. Social Aspects of Population Health. Vol. 66. No. 4. P. 1—5. https://doi.org/10.21045/2071-5021-2020-66-4-4. (In Russ.)
Anufriyeva V., Pavlova M., Stepurko T., Groot W. (2021) The Validity and Reliability of Self-Reported Satisfaction
With Healthcare as a Measure of Quality: A Systematic Literature Review. International Journal for Quality in Health Care. Vol. 33. No. 1. Art. mzaa152. https://doi.org/10.1093/intqhc/mzaa152.
AlSaud A.M., Taddese H.B., Filippidis F.T. (2018) Trends and Correlates of the Public’s Perception of Healthcare Systems in the European Union: A Multilevel Analysis of Eurobarometer Survey Data From 2009 to 2013. BMJ Open. Vol. 8. No. 1. Art. e018178. https://doi.org/10.1136/bmjopen-2017-018178.
Batbaatar E. et al. (2017) Determinants of Patient Satisfaction: A Systematic Review. Perspectives in Public Health. Vol. 137. No. 2. P. 89—101. https://doi.org/10.1177/17579139166341.
Borowska M., Religioni U., Augustynowicz A. (2022) Patients’ Opinions on the Quality of Services in Hospital Wards in Poland. International Journal of Environmental Research and Public Health. Vol. 20. No. 1. Art. 412. https://doi.org/10.3390/ijerph20010412.
Bull C. (2021) Patient Satisfaction and Patient Experience Are Not Interchangeable Concepts. International Journal for Quality in Health Care. Vol. 33. No. 1. Art. Mzab023. https://doi.org/10.1093/intqhc/mzab023.
Buller M. K., Buller D. B. (1987) Physicians' Communication Style and Patient Satisfaction. Journal of Health and Social Behavior. Vol. 28. No. 4. P. 375—388. https://doi.org/10.2307/2136791.
Cleary P. D., McNeil B. J. (1988) Patient Satisfaction as an Indicator of Quality Care. Inquiry. Vol. 25. No. 1. P. 25—36.
Dunsch F. et al. (2018) Bias in Patient Satisfaction Surveys: A Threat to Measuring Healthcare Quality. BMJ Global Health. Vol. 3. No. 2. Art. E000694. https://doi.org/0.1136/bmjgh-2017-000694.
Edwards C., Staniszewska S., Crichton N. (2004) Investigation of the Ways in Which Patients’ Reports of Their Satisfaction with Healthcare Are Constructed. Sociology of Health & Illness. Vol. 26. No. 2. P. 159—183. https://doi.org/10.1111/j.1467-9566.2004.00385.x.
Ferreira D. C., Vieira I., Pedro M.I., Caldas P., Varela M. (2023) Patient Satisfaction with Healthcare Services and the Techniques Used for Its Assessment: A Systematic Literature Review and a Bibliometric Analysis. Healthcare. Vol. 11. No. 5. Art. 639. https://doi.org/10.3390/healthcare11050639.
Gill L., White L. (2009) A Critical Review of Patient Satisfaction. Leadership in Health Services. Vol. 22. No. 1. P. 8—19. https://doi.org/10.1108/17511870910927994.
Gille F., Smith S., Mays N. (2017) Towards a Broader Conceptualisation of ‘Public Trust’ in the Health Care System. Social Theory & Health. Vol. 15. P. 25—43. https://doi.org/10.1057/s41285-016-0017-y.
Gille F., Smith S., Mays N. (2021) What Is Public Trust in the Healthcare System? A New Conceptual Framework Developed from Qualitative Data in England. Social Theory & Health. Vol. 19. P. 1—20. https://doi.org/10.1057/s41285-020-00129-x.
Hekkert K. D., Cihangir S., Kleefstra S.M., van den Berg B., Kool R.B. (2009) Patient Satisfaction Revisited: A Multilevel Approach. Social Science & Medicine. Vol. 69. No. 1. P. 68—75. https://doi.org/10.1016/j.socscimed.2009.04.016.
Lochman J. E. (1983) Factors Related to Patients’ Satisfaction with Their Medical Care. Journal of Community Health. Vol. 9. No. 2. P. 91—109. https://doi.org/10.1007/BF01349873.
Locker D., Dunt D. (1978) Theoretical and Methodological Issues in Sociological Studies of Consumer Satisfaction with Medical Care. Social Science & Medicine. Part A: Medical Psychology & Medical Sociology. Vol. 12. P. 283—292. https://doi.org/10.1016/0271-7123(78)90067-6.
Mossialos E. (1997) Citizens’ Views on Health Care Systems in the 15 Member States of the European Union. Health Economics. Vol. 6. No. 2. P. 109—116. https://doi.org/10.1002/(SICI)1099-1050(199703)6:2<109::AID-HEC251>3.0.CO;2-L.
Naidu A. (2009) Factors Affecting Patient Satisfaction and Healthcare Quality. International Journal of Health Care Quality Assurance. Vol. 22. No. 4. P. 366—381. https://doi.org/10.1108/09526860910964834.
Pelikan J. M., Link T., Straßmayr C., Waldherr K., Alfers T., Bøggild H., Griebler R., Lopatina M., Mikšová D., Nielsen M.G., et al. (2022) Measuring Comprehensive, General Health Literacy in the General Adult Population: The Development and Validation of the HLS19-Q12 Instrument in Seventeen Countries. International Journal of Environmental Research and Public Health. Vol. 19. No. 21. Art. 14129. https://doi.org/10.3390/ijerph192114129.
Sari M. I., Prabandari Y. S., Claramita M. (2016) Physicians’ Professionalism at Primary Care Facilities from Patients’ Perspective: The Importance of Doctors’ Communication Skills. Journal of Family Medicine and Primary Care. Vol. 5. No. 1. P. 56—60. https://doi.org/10.4103%2F2249-4863.184624.
Sitzia J., Wood N. (1997) Patient Satisfaction: A Review of Issues and Concepts. Social Science & Medicine. Vol. 45. No. 12. P. 1829—1843. https://doi.org/10.1016/S0277-9536(97)00128-7.
Van Der Schee E., Braun B., Calnan M., Schnee M., Groenewegen P. P. (2007) Public Trust in Health Care: A comparison of Germany, The Netherlands, and England and Wales. Health Policy. Vol. 81. No. 1. P. 56—67. https://doi.org/10.1016/j.healthpol.2006.04.004.
Ware Jr. J. E., Snyder M. K., Wright W. R., & Davies A. R. (1983) Defining and Measuring Patient Satisfaction with Medical Care. Evaluation and Program Planning. No. 6. Vol. 3—4. P. 247—263. https://doi.org/10.1016/0149-7189(83)90005-8.
Weinhold I., Gurtner S. (2018). Rural-Urban Differences in Determinants of Patient Satisfaction with Primary Care. Social Science & Medicine. Vol. 212. P. 76—85. https://doi.org/10.1016/j.socscimed.2018.06.019.
Weiss G. (1988) Patient Satisfaction with Primary Medical Care Evaluation of Sociodemographic and Predispositional Factors. Medical Care. Vol. 26. No. 4. P. 383—392. https://doi.org/10.1093/hsw/16.4.281.
Williams S., Weinman J., Dale J. (1998) Doctor-Patient Communication and Patient Satisfaction: A Review. Family Practice. Vol. 5. No. 15. P. 480—492. https://doi.org/10.1093/fampra/15.5.480.
Xesfingi S., Vozikis A. (2016) Patient Satisfaction with the Healthcare System: Assessing the Impact of Socio-Economic and Healthcare Provision Factors. BMC Health Services Research. Vol. 16. Art. 94. https://doi.org/10.1186/s12913-016-1327-4.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Monitoring of Public Opinion: Economic and Social Changes
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
