Institute of Public Health of Serbia Mirjana Živković-Šulović, md


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III Biannual International Conference on the Future of Primary Care in Europe Patients’ rights thruogh their eyes in public health institutions in Serbia

  • Institute of Public Health of Serbia
  • Mirjana Živković-Šulović, MD
  • Pisa, Italy, 30.-31. August 2010

Institute of Public Health of Serbia “Dr Milan Jovanovic Batut” http://www.batut.org.rs

  • HIF
  • Providers
  • (All levels)
  • MoH
  • PHI +
  • PHI network
  • Center for Analysis, Planing and
  • Organization of Health Care
  • Main activites
  • Health analysis and planning, health
  • monitoring and reporting, planning
  • of health services, analysis of
  • health risks in the community
  • and quality assurance of health care.

Purpose and Method

  • To check implementation of some patients’ right five years after legislation in Low of Health (2005) and to research correlation with patients satisfaction.
  • National patients' survey in December 2009. A structured questionnaire was completed by patients, after receiving the health care service in 87 hospitals (five day population) and 163 primary health care facilities (one day population).
  • Overall patient satisfaction was measured using a five point ordinal scale.
  • Statistics’ method: frequency distribution, Chi-squared test and multiple linear regression.
  • Significance level (p) less than 0.05 was considered as statistically significant.

Legislation and regulation

  • Important aspects of patients’ rights have been addressed in the Law on Health Care Protection (2005), including the following topics:
  • Availability of health care according to health needs, resources and equal access
  • Rights and obligations related to compulsory health insurance
  • Information to the patient + inform to duties
  • Free choice for patients (including choice of doctor)
  • Privacy and confidentiality of information and data
  • Self-determination and informed consent
  • Access to medical documentation
  • Dissatisfaction and complaints
  • Liability and compensation in case of health damage or harm
  • Public information on health protection (e.g. in work or in the event of epidemics).

Patient satisfaction survey with hospital care (1)

  • 07.-12.12.2009.; 10.394 respondents; 87 hospitals
  • Did you give written or oral consent to the procedures and treatment?
  • Yes 89.3%
  • No 10,7%
  • χ2 =112,976, df=3, p≤0.000

Patient satisfaction survey with hospital care (2)

  • Did staff informe you about your duties in hospital?
  • Yes 87,8%
  • No 12,2%
  • χ2 =126,922, df=3, p≤0.000

Patient satisfaction survey with hospital care (3)

  • Do you aware of the appeals and complaints mechanism?
  • Yes 76,4%
  • No 23,6%
  • χ2 =298,939, df=3, p≤0.000

Patient satisfaction survey with hospital care (4)

  • How much are you satisfide with given informatin about tests, procedures, tretman and results? (five ordinal scale from very dissetisfide to very setisfide)
  • Dissetisfide
  • Nurses 2,2%
  • Doctors 2,2%

Patient satisfaction survey with PHC servicies general practis, pedijatrics & gynecologist (1)

  • 07.12.2009.; 57.527 respondents, 171 PHC facilities
  • How did you choose your doctor?
  • I chose my doctor 81,4%
  • Member of my family chose insted of me 6,6%
  • Did not choose, I get it 3,8%
  • I do not have chosen doctor 5,5%
  • Do not rememmber 2,7%
  • χ2 =597,487, df=8, p≤0.000

Patient satisfaction survey with PHC servicies general practis, pedijatrics & gynecologist (2)

  • Do you awere how to make new choise of doctor if you wont?
  • Yes, I can do it when ever I wish 40,2%
  • Yes, but I can do it ones per year 32,1%
  • I think it is not possible 3,7%
  • Do not know 23,9%

Patient satisfaction survey with PHC servicies general practis, pedijatrics & gynecologist (3)

  • My chosen doctor give me clear information of diseases and drugs.
  • Yes, I agree 84,8%
  • Partly agree 12,6%
  • Do not agree 2.6%
  • χ2 = 16.087, df = 4, p < 0.03

Patient satisfaction survey with PHC servicies general practis, pedijatrics & gynecologist (4)

  • There is a box/book for complaints and appeals in PHC servise
  • Yes, I agree 73%
  • Partly agree 5,7%
  • Do not agree 3,7%
  • Do not know 17,6%
  • χ2 =209,775, df=6, p≤0.000

Conclusion (1)

  • Multiple regression test confirmed that all the variables related to patients’ rights are statistically highly significant on overall satisfaction with health care (p <0.000).

Conclusion (2)

  • Almost 50% patients are not completely aware about their rights after two campaigns. We need beter strategy.
  • There is a statistically significant difference on patient awareness about the rights to the various hospital departments or PHC servicies.
  • These results show that there is need for special research of this issue. We should check medical staff also.
  • Patients’ rights is an efficient tool for quality control, risk management, conflict resolution and prevention of litigation.
  • Uh…

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