Organizational and economic factors of assessing the management of accessibility and quality of medical care in the Republic of Tatarstan

Abstract

BACKGROUND: Today, when assessing the availability and quality of medical care, objective criteria and indicators prevail, and the factor of patient feedback as end consumers is practically not taken into account, which does not allow us to form a comprehensive view and get closer to solving this problem.

AIM: To identify the factors that have the greatest impact on patients' assessment of the availability and quality of medical care, to study the influence degree of organizational and economic problems of medical organizations on this assessment and to develop quantitative indicators for managing this indicator.

MATERIAL AND METHODS: The study was conducted using a questionnaire from October to December 2023 based on medical organizations of the Republic of Tatarstan. Two types of questionnaires were compiled. The first questionnaire was for consumers of medical care, covering 2,419 patients of hospitals and clinics from all cities and districts of the Republic of Tatarstan. The second questionnaire was for medical personnel. A total of 20,330 medical workers took part in the survey: 5,206 doctors, 10,841 nurses, 4,283 junior medical personnel from all types of medical organizations, including central republican hospitals, city and district hospitals and clinics of Tatarstan. The results of the questionnaires were processed by means of correlation and regression analysis using the least squares method.

RESULTS: It was revealed that for patients of medical organizations the most significant factors in assessing the quality of medical care were: (1) queues and constant waiting (50.5% of respondents); (2) inability to see a specialist (48.9%); (3) unavailability of diagnostic procedures (biochemical blood test, computed tomography and magnetic resonance imaging, ultrasound; 40.7%); (4) inattention, indifference of medical workers (27.5%). Factors in the work of medical institutions and personnel that had the greatest impact on patients' assessments of the indicator of availability and quality of medical care were identified: stress at work, overload and high work pressure, dissatisfaction with salary. The regression coefficients of the identified factors allow them to be used as indicators of management decisions aimed at increasing the importance of availability and quality of medical care.

CONCLUSION: Patient assessments obtained by medical organizations as a result of feedback allow not only to bring the level of availability and quality of medical care as close as possible to the expectations and needs of patients, but also to identify areas of management influence to improve it.

Keywords

quality of medical care / patient satisfaction / medical personnel / work overload / stress / level of salary

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