Socio-demographic characteristics of the participants
Among the 177 participants, 89 (50.3 %) were from Yekatit 12 Hospital Medical College, and the rest were from Menelik II Referral Hospital, yielding a response rate of 96.7 % and 95.7 %, respectively.
Eighty-nine (50.3 %) of those polled were under the age of 35. The average age of the respondents at Yekatit HMC was 40±14.2 years and 33.4±9.2 years at Menelik II Referral Hospital. The median monthly household income of the participants was 3000 ETB (66.7USD), (Table 1).
Table 1
shows the socio-demographic characteristics of study participants from Yekatit 12 Hospital Medical College and Menelik II Referral Hospital in Addis Ababa, Ethiopia, in 2021.
Variables | Category | Yekatit 12 HCM N(%) | Menelik II RH N(%) | Total N(%) |
Site | 8 | 89(50.3%) | 88(49.7%) | 177(100%) |
Sex | Male | 31(34.8%) | 40(45.5%) | 71(40.1%) |
Female | 58(65.2%) | 48(54.5%) | 106(59.9%) |
Age | <34years | 34(38.2%) | 55(62.5%) | 89(50.3%) |
35-54 years | 37(41.6% | 32(36.4%) | 69(39%) |
>55 years | 18(20.2%) | 1(1.1%) | 19(10.7%) |
Marital status | Single | 16(18%) | 28(31.8%) | 44(24.9%) |
Married | 65(73%) | 56(63.6%) | 121(68.4%) |
Others | 8(9%) | 4(4.5%) | 12(6.8%) |
Educational status | No formal education | 20(22.47%) | 6(6.8%) | 26(14.7%) |
Primary school | 10(11.2%) | 13(14.8%) | 23(13%) |
Secondary school | 28(31.5%) | 29(33%) | 57(32.2%) |
Diploma | 21(23.6%) | 17(19.3%) | 38(21.5%) |
Degree and more | 10(11.2%) | 23(26.1%) | 33(18.6%) |
Occupation | Gov.Employee | 16(18%) | 29(33%) | 45(25.4%) |
private employed | 35(39.3%) | 26(29.5%) | 61(34.5%) |
student | 2(2.2%) | 10(11.4%) | 12(6.8%) |
Merchant | 5(5.6%) | 5(5.7%) | 10(5.6%) |
Daily labourer | 4(4.5%) | 2(2.3%) | 6(3.4%) |
Unemployed | 27(30.3%) | 16(18.2%) | 43(24.3%) |
Monthly Income | < 1500 EB | 30(33.7%) | 27(30.7%) | 57(32.2%) |
≥1500 EB | 50(66.3%) | 61(69.3%) | 120(67.8%) |
Educational Status | No formal education | 20(22.5%) | 6(6.8%) | 26(14.7%) |
Primary school | 10(11.2% | 13(14.8%) | 23(13%) |
Secondary school | 28(31.5%) | 29(33%) | 57(32.2%) |
College diploma | 21(23.6% | 17(19.3%) | 38(21.5%) |
Degree and above | 10(11.2% | 23(26.1%) | 33(18.6%) |
Service-Related characteristics of the participants
Participants were assessed for their OPD waiting time at both Hospitals that 52(58.4%) and 38(43.1%) were waiting for less than one hour at Yekatit 12 Hospital Medical College and Menelik II Referral Hospital respectively.The mean emergency waiting time at Yekatit 12 HMC was 32.8 minutes, while at Menelik II Referral Hospital it was 71 minutes[Fig. 3].
Sixty seven percent of respondents agreed that registration of general information at triage was faster at Yekatit 12 HMC compared to 24 % at Menelik II Referral Hospital. Sixty-two (69.7%) of respondents at Yekatit 12 HMC were satisfied and comfortable with the overall waiting area of the service, compared to only 22.7% at Menelik Referral Hospital.
During their stay, treating health workers called the names of 82 (92.3%) and 59 (67%) of respondents at Yekatit 12 HMC and Menelik Hospital, respectively. Similarly, 96.6 % of Yekatit 12 HMC agreed that they listened to their wishes, while 81.8 % of Menelik agreed. Y12HMC and Menelik II Referral Hospital treating clinicians assisted 79 (88.8%) and 63 (71.6%) patients respectively in making a decision about their medical problems[Table 3].
Table 3
Service-related Level of satisfaction with Likert-scale of study participants at Y12 HMC and Menelik II Referral Hospital, Addis Ababa, 2021.
Variables | Study Sites | Level of satisfaction |
Strongly agree | Agree | Neutral | Disagree | Strongly disagree |
Accessed to medical care whenever you need | Yekatit12 HMC | 59(66.3%) | 16(18%) | 4(4.5%) | 6(6.7%) | 4(4.5%) |
Menelik II RH | 10(11.4%) | 31(35.2%) | 16(18.2%) | 20(22.7%) | 11(12.5%) |
Registration of general information at triage is shorter. | Yekatit12 HMC | 48(53.9%) | 22(24.7) | 4(4.5%) | 11(12.4%) | 4(4.5%) |
Menillik II RH | 9(10.2%) | 23(26.1%) | 7(8%) | 31(35.2%) | 18(20.5%) |
Comfortable with Overall waiting area of services | Yekatit12HMC | 53(59.6%) | 15(16.9%) | 2(2.2%) | 11(12.4%) | 8(9%) |
Menelik II RH | 7(8.0%) | 23(26.1%) | 7(8.0%) | 33(37.5%) | 18(20.5%) |
Had eye contact while examination | Yekatit 12 HMC | 63(70.8%) | 19(21.3%) | 2(2.2%) | 4(4.5%) | 1(1.1%) |
Menelik II RH | 12(13.6%) | 44(50%) | 12(13.6%) | 8(9.1%) | 12(13.6%) |
Health care workers communicated with me by calling my name | Yekatit 12 HMC | 71(79.8%) | 11(12.4%) | 2(2.2%) | 4(4.5%) | 1(1.1%) |
Menelik II RH | 11(12.5%) | 48(54.5%) | 6(6.8%) | 13(14.8%) | 10(11.4%) |
Listened to my wishes concerning my care. | Yekatit 12 HMC | 74(83.1%) | 12(13.5%) | 1(1.1%) | 1(1.1%) | 1(1.1%) |
Menelik II RH | 19(21.6%) | 53(60.2%) | 5(5.7%) | 8(9.1%) | 3(3.4%) |
Respect is shown by Health care workers | Yekatit 12 HMC | 75(84.3%) | 12(13.5%) | 1(1.1%) | 0 | 1(1.1%) |
Menelik II RH | 19(21.6%) | 44(50%) | 6(6.8%) | 5(5.7%) | 14(15.9%) |
My privacy was maintained | Yekatit12HMC | 67(75.3%) | 13(14.6%) | 1(1.1%) | 6(6.7%) | 2(2.2%) |
Menelik II RH | 21(23.9%) | 46(52.3%) | 3(3.4%) | 7(8%) | 11(12.5%) |
Explanation of medical procedures is good | Yekatit 12 HMC | 53(59.6%) | 17(19.1%) | 7(7.9%) | 4(4.5%) | 8(9%) |
Menelik II RH | 9(10.2%) | 26(29.5%) | 7(8%) | 28(31.8%) | 18(20.5%) |
Explanation of Laboratory tests is good | Yekatit 12 HMC | 43(48.3%) | 16(18%) | 13(14.6%) | 7(7.9%) | 10(11.2%) |
Menelik II RH | 12(13.6%) | 23(26.1%) | 8(9.1%) | 23(26.1%) | 22(25%) |
Health care workers helped me take part in decisions concerning my care. | Yekatit 12 HMC | 64(71.9%) | 15(16.9%) | 5(5.6%) | 1(1.1%) | 4(4.5%) |
Menillik II RH | 32(36.4%) | 32(36.4%) | 6(6.8%) | 9(10.2%) | 9(10.2%) |
Searching for patient medical records was the most common reason for them waiting longer than expected, accounting for 55 (72.4 %), followed by patient load, with each scoring 50 %. At Y12 HMC and Menelik II Referral Hospital, the results of searching for patient medical records (34.8 %, 88.7 % ), jumping the queue system (56.5 %, 47.2 % ), and late arrival of treating physicians (13 %, 37.7%) respectively.[Table 2]
Table 2
Common reasons why they were waiting longer than their expectation at Y12HMC and Menelik II Referral Hospital, Addis Ababa, 2021.
variables | category | Yeakatit 12 HMC | Menelik II RH | Total N(%) |
Did Doctor arrive late? | Yes | 3(13%) | 20(37.7%) | 23(30.2%) |
No | 15(65.2%) | 22(41.5%) | 37(48.7%) |
Don’t know | 5(21.7%) | 11(20.8%) | 16(21.1%) |
Searching Patient's medical record takes longer? | Yes | 8(34.8%) | 47(88.7%) | 55(72.4%) |
No | 14(60.9%) | 5(9.4%) | 19(25.0%) |
Don’t know | 1(4.3%) | 1(1.9%) | 2(2.6%) |
Large numbers of patients with few doctors | Yes | 13(56.5%) | 25(47.2%) | 38(50.0%) |
No | 8(34.8%) | 19(35.8%) | 27(35.5%) |
Don’t know | 2(8.7%) | 9(17%) | 11(14.5%) |
Patients jumping queue | Yes | 13(56.5%) | 25(47.2%) | 38(50.0%) |
No | 9(39.1%) | 23(43.4%) | 32(42.1%) |
Don’t know | 1(4.3%) | 5(9.4%) | 6(7.9%) |
Sign and direction indicators were available to ease ways | Yes | 9(39.1%) | 22(41.5%) | 31(40.8%) |
No | 12(52.2%) | 23(43.4%) | 35(46.1%) |
Don’t know | 2(8.7%) | 8(15.1%) | 10(13.2%) |
In terms of satisfaction level, variables that remained significant with multivariable logistic regression were found to be waiting longer than expected [AOR=0.168;95 % CI (0.044,0.642)], accessibility to medical care whenever needed [AOR=5.911; 95% CI(1.516,23.043)], comfort with the overall waiting area of the service [AOR=9.514; 95% CI(2.591,34.931)], explanation of the medical procedure to the patient by health care workers [AOR=7.466; 95% CI(1.693,32.919)], health care workers' involvement in deciding on their medical care [AOR=19.1]
Regarding the level of satisfaction, variables that remained significant with multivariable logistic regression are waiting longer than their expectation [AOR=5.78;95% CI (1.44,23.21)], accessibility to medical care whenever needed [AOR=5.67; 95% CI(1.36,23.62)], comfortable with the overall waiting area of the service [AOR=8.07;95% CI(2.09,31.19)], explanation of the medical procedure to the patient by health care workers [AOR=5.5;95% CI(1.34,26.65)], Health care workers' help that involved the clients to decide on their medical care [AOR=23.79;95% CI (3.99,140.58)].
Good explanation of the medical procedures 5 times more likely satisfied than those who were not explained about the procedure and laboratory tests is highly associated with patient satisfaction which increased satisfaction 4 times more than those with no explanation. However, no statistically significant associations were observed between study site, registration at the reception, waiting for the area, eye contact with their treating physician, communication, laboratory test explanation, respect, and maintenance of privacy, frequency of visiting the center, or time spent with the physician during the examination.[Table 4].
Table 4
Satisfaction with Quality of Care Among Patients at Yekatit 12 Hospital Medical College and Menelik II Referral Hospital, Addis Ababa, July 2021.(Logistic Regression Analysis-Adjusted )
Variables | Category | Level of satisfaction |
Y12 HMC N(%) | Menelik II RH N(%) | COR(95%CI) | AOR(95%CI) | P-value |
Do you wait longer than your expected? | Yes | 23(25.8) | 53(60.2) | 1 | 1 | 0.009 |
No | 66(74.2) | 35(39.8) | 8.28(4.191,16.337)* | 0.168(0.044,0.642)** |
Accessed to medical care whenever you need | Agree | 75(84.3) | 41(46.6) | 16.54(7.51,36.41)* | 5.911(1.516,23.043)** | 0.010 |
Disagree | 14(15.7) | 47(53.4) | 1 | 1 |
Registration of general information at triage is shorter. | Agree | 70(78.7) | 32(36.4) | 9.92(4.95,19.89)* | 2.839(0.797,10.111) | 0.107 |
Disagree | 19(21.3) | 56(63.6) | 1 | 1 |
Comfortable with Overall waiting area of services | Agree | 68(76.4) | 30(34.1) | 15.12(7.23,31.61)* | 9.514(2.591,34.931)** | 0.001 |
Disagree | 21(23.6) | 58(65.9) | 1 | 1 |
Explanation of medical procedures is good | Agree | 70(78.7) | 35(39.8) | 18.367(8.570,39.362)* | 7.466(1.693,32.919)** | 0.008 |
Disagree | 19(21.3) | 53(60.2) | 1 | 1 |
Explanation of Laboratory tests is good | Agree | 59(66.3) | 35(39.8) | 13.739(6.608,2858.988)* | 3.176(0.795,12.684) | 0.102 |
Disagree | 30(33.7) | 53(60.2) | 1 | 1 |
Health care workers helped me take part in decisions concerning my care. | Agree | 79(88.8) | 64(72.7) | 16.333(5.430,49.134)* | 19.146(3.594,102.00)** | 0.001 |
Disagree | 10(12.2) | 24(27.3) | 1 | 1 |
Respect was shown by Health care workers | Agree | 87(97.8) | 63(71.6) | 15.529(4.463,54.033)* | 5.909(0.636,54.871) | 0.118 |
Disagree | 2(2.2) | 25(28.4) | 1 | 1 |
Listened to my wishes concerning my care. | Agree | 86(96.6) | 72(81.8) | 14.655(3.269,65.709)* | 1.369(0.115,16.297) | 0.804 |
Disagree | 3(3.4) | 16(18.2) | 1 | 1 |
In general, this research found that 74 (83.1 %) of Yekatit 12 HMC respondents were satisfied with overall outpatient services (OPD and Emergency), whereas those at Menelik II Referral Hospital it was 31.8% [Fig. 2, additional file 2]