title: Evaluation of patients' satisfaction with quality of care provided at the National Health Insurance Scheme clinic of a tertiary hospital in South- Eastern Nigeria.
abstract: BACKGROUND
  The umpteenth threats to change of healthcare provider by dissatisfied patients on formal sector health insurance are well known and can be a proxy indicator for the need for quality improvement in service delivery.
  
  
  OBJECTIVE
  This study was aimed at evaluating patients' satisfaction with quality of care provided at the National Health Insurance Scheme (NHIS) clinic of a tertiary hospital in South-Eastern Nigeria.
  
  
  METHODS
  This was a descriptive study carried out on 400 NHIS patients from April 2011 to October 2011 at the general outpatient department of Federal Medical Centre, Umuahia. Patients were selected by simple random sampling using every second NHIS patient that registered to see the clinicians and who met the selection criteria. Data were collected using pretested, structured interviewer-administered questionnaire. Each satisfaction item was scored in a five-point Likert scale ordinal response, which was converted to percentage scale response. Satisfaction was measured from the following domains: accessibility, patient waiting time, patient-provider communication, patient-provider relationship, hospital bureaucracy, and hospital environment. Operationally, patients who scored 50% and above in the assessed domain were considered satisfied while those who scored less than 50% were dissatisfied.
  
  
  RESULTS
  The overall satisfaction score of the respondents was 66.8%. Specifically, the respondents expressed satisfaction with patient-provider relationship (81.5%), patient-provider communication (79.9%), accessibility (74.2%), and hospital environment (68.2%) and dissatisfaction with hospital bureaucracy (48.8%) and patient waiting time (48.3%).
  
  
  CONCLUSIONS
  This study has shown that the overall patients satisfaction with the services provided was very good with patient-provider relationship rated highest and patient waiting time the lowest. There is need to improve on the current level of patients satisfaction while effort should be made to address the identified domains of dissatisfaction.
authors.affiliation: Department of Family Medicine, Federal Medical Centre, Umuahia, Abia State, Nigeria. ilohgup2009@yahoo.com
authors.forename: G U P
authors.initials: GU
authors.lastname: Iloh
authors.forename: J N
authors.initials: JN
authors.lastname: Ofoedu
authors.forename: P U
authors.initials: PU
authors.lastname: Njoku
authors.forename: F U
authors.initials: FU
authors.lastname: Odu
authors.forename: C V
authors.initials: CV
authors.lastname: Ifedigbo
authors.forename: K D
authors.initials: KD
authors.lastname: Iwuamanam
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities; D015331:Cohort Studies; D005260:Female; D006297:Health Services Accessibility; D006801:Humans; D008297:Male; D008875:Middle Aged; D009313:National Health Programs; D009549:Nigeria; D017060:Patient Satisfaction; D062606:Tertiary Care Centers; D055815:Young Adult