Exploring the Relationship between Accreditation and Patient Satisfaction – The Case of Selected Lebanese Hospitals

Document Type : Original Article

Authors

1 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada

2 Department of Health Management and Policy, Faculty of Health Sciences, American University of Beirut, Beirut, Lebanon

3 Department of Health Management and Policy, College of Public Health, University of Iowa, Iowa City, IA, USA

Abstract

Background
Patient satisfaction is one of the vital attributes to consider when evaluating the impact of accreditation systems. This study aimed to explore the impact of the national accreditation system in Lebanon on patient satisfaction.
 
Methods
An explanatory cross-sectional study of six hospitals in Lebanon. Patient satisfaction was measured using the SERVQUAL tool assessing five dimensions of quality (reliability, assurance, tangibility, empathy, and responsiveness). Independent variables included hospital accreditation scores, size, location (rural/urban), and patient demographics.
 
Results
The majority of patients (76.34%) were unsatisfied with the quality of services. There was no statistically significant association between accreditation classification and patient satisfaction. However, the tangibility dimension – reflecting hospital structural aspects such as physical facility and equipment was found to be associated with patient satisfaction.
 
Conclusion
This study brings to light the importance of embracing more adequate patient satisfaction measures in the Lebanese hospital accreditation standards. Furthermore, the findings reinforce the importance of weighing the patient perspective in the development and implementation of accreditation systems. As accreditation is not the only driver of patient satisfaction, hospitals are encouraged to adopt complementary means of promoting patient satisfaction.

Keywords

Main Subjects


  1.  

    1. Greenfield D, Braithwaite J. Health sector accreditation research: a systematic review. Int J Qual Health Care2008;20: 172-83. doi: 10.1093/intqhc/mzn005
    2. Jovanovic B. Hospital Accreditation as Method for Assessing Quality in Healthcare. Arch Oncol2005; 13: 156-7.
    3. Ammar W, Wakim IR, Hajj I. Accreditation of hospitals in Lebanon: a challenging experience. East Mediterr Health J2007; 13: 138-49.
    4. Tzeng HM, Chang Y. Patient satisfaction versus quality. Nurs Ethics 2008; 15: 121-4. doi: 10.1177/0969733007080210
    5. Labarere J, Francois P, AuquierP, Robert C, Fourny M. Development of a French inpatient satisfaction questionnaire. Int J Qual Health Care 2001; 13: 99-108. doi: 10.1093/intqhc/13.2.99
    6. Shaikh BT, Mobeen N, Azam SI, Rabani F. Using SERVQUAL for assessing and improving patient satisfaction at a rural health facility in Pakistan. East Mediterr Health J2008; 14: 447-56.
    7. Grol R. Improving the Quality of Medical care: Building Bridges Among Professional Pride, Payer Profit, and Patient Satisfaction. JAMA 2001; 286: 2578-85. doi: 10.1001/jama.286.20.2578
    8. Bell R, Krivich MJ, Boyd MS. Charting patient satisfaction. Mark Health Serv 1997; 17: 22-9.
    9. Draper M, Cohen P, Buchan H. Seeking consumer views: What use are results of hospital patient satisfaction surveys? Int J Qual Health Care 2001;  13: 463-8. doi: 10.1093/intqhc/13.6.463
    10. Walker R, Johnson L, Leonard S. Re-thinking the conceptualization of customer value and service quality within the service-profit chain. Manag Serv Qual2006; 16: 23-36.  doi: 10.1108/09604520610639946
    11. Heuer AJ. Hospital Accreditation and Patient Satisfaction: Testing the Relationship. J Healthc Qual2004; 26: 46-51. doi: 10.1111/j.1945-1474.2004.tb00471.x
    12. Hayati NI, Azimatun NA, Rozita H, Ezat WA, Rizal AM. In-Patients’ Satisfaction In The Medical And Surgical Wards – A Comparison Between Accredited And Non Accredited Hospital In The State Of Selangor. J Commun Health 2010; 16: 60-8.
    13. Sack C, Lütkes P, Günther W, Erbel R, Jockel K, Holtmann JG. Challenging the holy grail of hospital accreditation: A cross sectional study of inpatient satisfaction in the field of cardiology. Health Serv Res2010;10: 120. doi: 10.1186/1472-6963-10-120
    14. Sack C, Scherag A, Lutkes P, Gunther W, Jockel KH, Holtmann G. Is there an association between hospital accreditation and patient satisfaction with hospital care? A survey of 37,000 patients treated by 73 hospitals. Int J Qual Health Care 2011; 23: 278-83. doi: 10.1093/intqhc/mzr011
    15. Heuvel J, Bogers A, Does R, Dijk S, Berg M. Quality Management: Does it Pay Off? Quality Management in Health Care 2006;15: 137-49. doi: 10.1097/00019514-200607000-00003
    16. El-Jardali F, Jamal D, Dimassi H, Ammar W, Tchaghchaghian V.The impact of hospital accreditation on quality of care: perception of Lebanese nurses. Int J Qual Health Care 2008; 20: 363-71. doi: 10.1093/intqhc/mzn023
    17. Ammar W. Health Beyond Politics. Beirut: World health organization eastern Mediterranean office; 2009.
    18. El-Jardali F. Hospital accreditation policy in Lebanon: Its potential for quality improvement. J Med Liban 2007; 55: 39-45.
    19. El-Jardali F, Makhoul J, Jamal D, Ranson M, Kronfol N, Tchaghchagian V. Eliciting policymakers’ and stakeholders’ opinions to help shape health system research priorities in the Middle East and North Africa region. Health Policy Plan 2009; 25: 15-27. doi: 10.1093/heapol/czp059
    20. Parasuraman A, Zeithaml VA, Berry LL. SERVQUAL: a multiple-item scale for measuring customer perceptions of service quality. J Retailing 1988; 64: 12-40.
    21. Buttle F. SERVQUAL: review, critique, research agenda. Eur J Marketing 1996; 30: 8-32.
    22. Mostafa MM. An empirical study of patients’ expectations and satisfactions in Egyptian hospitals. Int J Health Care Qual Assur Inc Leadersh Health Serv2005; 18: 516-32.
    23. Babakus E, Mangold WG. Adapting the SERVQUAL scale to the health care environment: an empirical assessment. In: Bloom P, Parasuraman A, editors. Enhancing Knowledge Development in Marketing. Chicago, IL: American Marketing Association; 1989.
    24. Babakus E, Mangold WG. Adapting the SERVQUAL scale to hospital services: an empirical investigation. Health Serv Res1992; 26: 767-86.
    25. Cronin J, Taylor S. Measuring service quality: a reexamination and extension. Journal of Marketing 1992; 56: 55-68. doi: 10.2307/1252296
    26. Cronin J, Taylor S. SERVPERF vs SERVQUAL: reconciling performances based perception – minus – expectations measurement of service quality. Journal of Marketing 1994; 58: 125-31. doi: 10.2307/1252256
    27. Mehta S, Durvasula S. Relationship Between SERVQUAL Dimensions and Organizational Performance in the Case of a Business-to-Business Service. Journal of Business & Industrial Marketing 1998; 13: 40-53. doi: 10.1108/08858629810206232
    28. Bowers M, Kiefe C. Measuring Healthcare Quality: Comparing and Contrasting the Medical and Marketing Approaches. Am J Med Qual2002; 17: 136-44. doi: 10.1177/106286060201700403
    29. Saleh S, Alameddine M, Natafgi M, Mourad Y. Quality of Care in Primary Health Care Settings in the Eastern Mediterranean Region: A Systematic Review of the Literature. 2014; Under review.
    30. Rahmqvist M. Patient satisfaction in relation to age, health status, and other background factors: a model for comparisons of care units. Int J Qual Health Care2001; 13: 385-90. doi: 10.1093/intqhc/13.5.385
    31. Sitzia J, Wood N. Patient satisfaction: A review of issues and concepts. Soc Sci  Med 1997;45: 1829-43. doi: 10.1016/s0277-9536(97)00128-7
    32. Abramowitz S, Cote A, Berry E. Analyzing patient satisfaction: a multianalytic approach. Quality Review Bulletin 1987; 13: 122-30.