LEVEL OF SERVICE SATISFACTION AND ITS ASSOCIATED FACTORS AMONG ORANG ASLI PATIENTS USING HEALTH TRANSIT CENTRES IN PERAK
DOI:
https://doi.org/10.37268/mjphm/vol.24/no.3/art.2336Keywords:
Orang Asli, indigenous, satisfaction, service quality, health transit centre, Orang Asli, Indigenous People, Service satisfaction, Health Transit CentreAbstract
Orang Asli, or Indigenous People are vulnerable community in Malaysia. Residing far from the hospitals, antenatal mothers are encouraged to stay in a temporary facility that serves as a transit centre between their home and hospitals for close health monitoring. Satisfaction from the Orang Asli community towards this centre is paramount for the continuous utilization and improving health equity. This study evaluated service satisfaction and identified influencing factors among Orang Asli patients using Health Transit Centres (OAHTCs) in Perak, Malaysia. A cross-sectional study was conducted across six OAHTCs, including a total of 360 participants, selected based on convenience sampling. Data were collected using the Ministry of Health (MOH) service quality (SERVQUAL) questionnaire, and logistic regression was used for inferential analysis. The results showed a response rate of 100%, with a median participant age of 26 years, the majority being female (95.3%). Males reported higher satisfaction levels (p=0.003), participants with no formal education and higher household income also had significant satisfaction rates (p<0.001). The duration of stay at the OAHTCs also significantly influenced satisfaction levels (p<0.001). The satisfaction level was 31.9% measured by the difference between perception and expectation. The SERVQUAL survey identified the largest service quality gaps in 'visually appealing physical facilities', 'up-to-date equipment', and 'staff understanding of patients’ needs'. Among the SERVQUAL dimensions, 'Tangible' showed the largest gap, followed by 'Professionalism' and 'Empathy'. This study underscores the importance of tangible elements, such as physical facilities and equipment, in shaping patients' satisfaction. In logistic regression, low education status (aOR 9.16; 95% CI: 4.45, 18.86; p<0.001), duration of stay less than 1 week (aOR 7.68; 95% CI: 4.10, 14.40; p<0.001) and male gender, (aOR 6.71; 95% CI: 2.10, 21.47; p=0.001), play a significant role in determining service satisfaction. The antagonistic interaction was also found between low education status and staying for less than one week (aOR 0.11; 95% CI: 0.04, 0.33; p<0.001). These findings can improve healthcare service delivery in OAHTCs and enhance health equity of Orang Asli community.
References
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41. Tokunaga, J. & Imanaka, Y. Influence of length of stay on patient satisfaction with hospital care in Japan. International Journal for Quality in Health Care 14, 493–502 (2002).
42. Zun, A. B., Ibrahim, M. I. & Hamid, A. A. Patients’ Expectations and Perceptions of Services Provided by Primary Health Clinics in Kota Bharu, Kelantan, Malaysia. Malaysian Journal of Medicine and Health Sciences 16, 2636–9346 (2020).
43. Prakash, B. Patient Satisfaction. J Cutan Aesthet Surg 3, 151 (2010).
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47. Handtke, O., Schilgen, B. & Mösko, M. Culturally competent healthcare – A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. PLoS One 14, (2019).
48. Althubaiti, A. Information bias in health research: definition, pitfalls, and adjustment methods. J Multidiscip Healthc 9, 211 (2016).
2. Friedel, A. L. et al. Measuring Patient Experience and Patient Satisfaction—How Are We Doing It and Why Does It Matter? A Comparison of European and U.S. American Approaches. Healthcare (Switzerland) 11, (2023).
3. Van Veghel, D. et al. Improving clinical outcomes and patient satisfaction among patients with coronary artery disease: An example of enhancing regional integration between a cardiac centre and a referring hospital. BMC Health Serv Res 20, 1–8 (2020).
4. Anderson, P. M., Krallman, R., Montgomery, D., Kline-Rogers, E. & Bumpus, S. M. The Relationship Between Patient Satisfaction With Hospitalization and Outcomes Up to 6 Months Post-Discharge in Cardiac Patients. J Patient Exp 7, 1685 (2020).
5. Setyawan, F. E. B., Supriyanto, S., Ernawaty, E. & Lestari, R. Understanding Patient Satisfaction and Loyalty in Public and Private Primary Health Care. https://doi.org/10.4081/jphr.2020.1823 9, 140–143 (2022).
6. El Dalatony, M. M. et al. Patient Satisfaction as a Determinant of Patient Loyalty to the Dentist in Dental Clinics. J Patient Exp 10, (2023).
7. Jeganathan, S. et al. Adherence and acceptability of telehealth appointments for high-risk obstetrical patients during the coronavirus disease 2019 pandemic. Am J Obstet Gynecol MFM 2, 100233 (2020).
8. Marzban, S., Najafi, M., Agolli, A. & Ashrafi, E. Impact of Patient Engagement on Healthcare Quality: A Scoping Review. J Patient Exp 9, (2022).
9. Aiken, L. H. et al. Patient satisfaction with hospital care and nurses in England: an observational study. BMJ Open 8, e019189 (2021).
10. Doyle, C., Lennox, L. & Bell, D. A systematic review of evidence on the links between patient experience and clinical safety and effectiveness. BMJ Open 3, e001570 (2013).
11. Hussen, M. A. & Worku, B. T. Quality of Antenatal Care Service and Factors Associated with Client Satisfaction at Public Health Facilities of Bele Gasgar District. J Patient Exp 9, (2022).
12. Bidmon, S., Elshiewy, O., Terlutter, R. & Boztug, Y. What Patients Value in Physicians: Analyzing Drivers of Patient Satisfaction Using Physician-Rating Website Data. J Med Internet Res 22, (2020).
13. Pashankar, D. S. et al. Sustained Improvement in Patient Experience by Optimizing Patient Flow in Ambulatory Settings. J Patient Exp 9, 1–6 (2022).
14. Hazazi, A. & Wilson, A. Experiences and Satisfaction of Patients with Non-Communicable Diseases with Current Care in Primary Health Care Centres in Saudi Arabia. J Patient Exp 9, (2022).
15. Akinlusi, F. M. et al. Patients’ Perception of the Quality of Gynecological Services in a Tertiary Public Health Facility in Lagos, Nigeria. J Patient Exp 9, (2022).
16. Tou, L. C., Jeyakumar, S. J., Siddiqui, T. A., Ravi, S. & Prakash, N. Understanding Patient Perceptions Towards Direct Primary Care: A Focus Group Study. J Patient Exp 9, (2022).
17. Chandra, S., Ward, P. & Mohammadnezhad, M. Factors associated with patient satisfaction in outpatient department of Suva sub-divisional health center, Fiji, 2018: A mixed method study. Front Public Health 7, 445025 (2019).
18. Tan, D. J. A., Sultana, R., Han, N. L. R., Sia, A. T. H. & Sng, B. L. Investigating determinants for patient satisfaction in women receiving epidural analgesia for labour pain: a retrospective cohort study. BMC Anesthesiol 18, (2018).
19. Wu, Q. et al. Patients satisfaction with healthcare delivery in Ghana. BMC Health Serv Res 21, 1–13 (2021).
20. Karaca, A. & Durna, Z. Patient satisfaction with the quality of nursing care. Nurs Open 6, 535 (2019).
21. Okunrintemi, V. et al. Association of Income Disparities with Patient-Reported Healthcare Experience. J Gen Intern Med 34, 884 (2019).
22. Du, L. et al. Rebuild doctor-patient trust in medical service delivery in China. Sci Rep 10, (2020).
23. Adhikary, G. et al. Factors influencing patients’ satisfaction at different levels of health facilities in Bangladesh: Results from patient exit interviews. PLoS One 13, e0196643 (2018).
24. Fang, J., Liu, L. & Fang, P. What is the most important factor affecting patient satisfaction – a study based on gamma coefficient. Patient Prefer Adherence 13, 515 (2019).
25. JAKOA. Pelan Strategik Jabatan Kemajuan Orang Asli 2016 - 2020. (2016).
26. JAKOA. Jadual Taburan Etnik Orang Asli Mengikut Negeri - Laman Web Rasmi Jabatan Kemajuan Orang Asli. https://www.jakoa.gov.my/orang-asli/jadual-taburan-etnik-orang-asli-mengikut-negeri/ (2020).
27. JKN Perak. Beban Kerja Transit Orang Asli di Negeri Perak 2016 - 2020. Jabatan Kesihatan Negeri Perak Preprint at (2016).
28. Roslan Johari, M. G., Roziana, S., Natrah, E., Evi Diana, O. & Mohd Idris, O. Workbook on SERVQUAL: KKM: Patient satisfaction survey using SPSS. (Institut Pengurusan Kesihatan., 2011).
29. Nordin, F. N., Khamis, N., Shanmugam, S., Jaaffar, F. S. A. & Ibrahim, N. H. Practicalities of SERVQUAL KKM Implementation in Ministry of Health Hospitals in Malaysia. J Health Manag 18, 87–105 (2022).
30. Zun, A. B., Ibrahim, M. I. & Hamid, A. A. Level of Satisfaction on Service Quality Dimensions Based on SERVQUAL Model Among Patients Attending 1 Malaysia Clinic in Kota Bharu, Malaysia. Oman Med J 33, 416 (2018).
31. Rahim, A. I. A., Ibrahim, M. I., Musa, K. I., Chua, S. L. & Yaacob, N. M. Patient Satisfaction and Hospital Quality of Care Evaluation in Malaysia Using SERVQUAL and Facebook. Healthcare (Basel) 9, (2021).
32. John, J., Yatim, F. M. & Mani, S. A. Measuring service quality of public dental health care facilities in Kelantan, Malaysia. Asia Pac J Public Health 23, 742–753 (2011).
33. Roder-DeWan, S. et al. Expectations of healthcare quality: A cross-sectional study of internet users in 12 low- and middle-income countries. PLoS Med 16, e1002879 (2019).
34. Mokhlis, S. The Influence of Service Quality on Satisfaction: A Gender Comparison. Public Administration Research 1, (2012).
35. Maharlouei, N., Akbari, M., Akbari, M. & Lankarani, K. B. Socioeconomic Status and Satisfaction with Public Healthcare System in Iran. Int J Community Based Nurs Midwifery 5, 22 (2017).
36. Qin, S. & Ding, Y. Who Is More Satisfied with Health Services? A Cross-Sectional Study in China. Inquiry 58, (2021).
37. Mosadeghrad, A. M. Factors influencing healthcare service quality. Int J Health Policy Manag 3, 77 (2014).
38. Paul, P., Hakobyan, M. & Valtonen, H. The association between self-perceived health status and satisfaction with healthcare services: Evidence from Armenia. BMC Health Serv Res 16, 1–13 (2016).
39. Saifullah, M. K., Masud, M. M. & Kari, F. B. Vulnerability context and well-being factors of Indigenous community development: a study of Peninsular Malaysia. https://doi.org/10.1177/1177180121995166 17, 94–105 (2021).
40. Thangiah, G., Said, M. A., Majid, H. A., Reidpath, D. & Su, T. T. Income Inequality in Quality of Life among Rural Communities in Malaysia: A Case for Immediate Policy Consideration. Int J Environ Res Public Health 17, 1–19 (2020).
41. Tokunaga, J. & Imanaka, Y. Influence of length of stay on patient satisfaction with hospital care in Japan. International Journal for Quality in Health Care 14, 493–502 (2002).
42. Zun, A. B., Ibrahim, M. I. & Hamid, A. A. Patients’ Expectations and Perceptions of Services Provided by Primary Health Clinics in Kota Bharu, Kelantan, Malaysia. Malaysian Journal of Medicine and Health Sciences 16, 2636–9346 (2020).
43. Prakash, B. Patient Satisfaction. J Cutan Aesthet Surg 3, 151 (2010).
44. McIntosh, N., Gruits, P., Oppel, E. & Shao, A. Built spaces and features associated with user satisfaction in maternity waiting homes in Malawi. Midwifery 62, 96–103 (2018).
45. van Braam, E. J., McRae, D. N., Portela, A. G., Stekelenburg, J. & Penn-Kekana, L. Stakeholders’ perspectives on the acceptability and feasibility of maternity waiting homes: a qualitative synthesis. Reprod Health 20, 101 (2023).
46. Kol, E., Ar?kan, F., ?laslan, E., Ak?nc?, M. A. & Koçak, M. C. A quality indicator for the evaluation of nursing care: determination of patient satisfaction and related factors at a university hospital in the Mediterranean Region in Turkey. Collegian 25, 51–56 (2018).
47. Handtke, O., Schilgen, B. & Mösko, M. Culturally competent healthcare – A scoping review of strategies implemented in healthcare organizations and a model of culturally competent healthcare provision. PLoS One 14, (2019).
48. Althubaiti, A. Information bias in health research: definition, pitfalls, and adjustment methods. J Multidiscip Healthc 9, 211 (2016).
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Published
2024-12-28
How to Cite
Ahmad Nizam, A. A., Ibrahim, K., Ruzlin, A. N. M., & Mun, L. K. (2024). LEVEL OF SERVICE SATISFACTION AND ITS ASSOCIATED FACTORS AMONG ORANG ASLI PATIENTS USING HEALTH TRANSIT CENTRES IN PERAK. Malaysian Journal of Public Health Medicine, 24(3), 167–177. https://doi.org/10.37268/mjphm/vol.24/no.3/art.2336
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