Background:Patients’ satisfaction with provided healthcare services is one of the factors to measure the overall quality of the delivered health care. Main objective of our study was to determine the common predictors associated with patients ‘satisfaction in three Balkan countries.Methods:We conducted web based survey among population in Macedonia, Serbia and Bulgaria using paid campaign over the social network Facebook. A questionnaire consisted of 31 questions was developed following studies on patients’ satisfaction conducted elsewhere. Descriptive analysis was performed to assess the predictors associated with patients’ satisfaction. In addition we performed content analysis to all open-ended responses.Results and discussion:In total 4118 respondents participated in the survey. Main predictors associated with low users satisfaction with the health care services in three surveyed countries are waiting time to appointments, huge administrative procedures, and attitudes of the medical personnel towards the patients. The analysis showed that there are many similarities in user experiences in three countries, but also there are some differences.Conclusions:The health care systems in these three counties are organized around centralized and monopolistic position of one health insurance fund that serves as main purchaser of health care services. Top three indicators of patients’ satisfaction across three countries are trust and overall satisfaction with the attention of the doctors, as well as satisfaction with the outcome of the treatment. Long waiting time and huge administrative procedures are determined as common predictor for lower patients’ satisfaction across these Balkan countries. Patients’ privacy protection is issue for concern in all three countries.
Discrimination scales can be adapted for use among Romani women and are associated with both smoking and psychological distress.
Background Roma are Europe's largest minority population. Serbia and Macedonia have the greatest proportion of Roma outside of the European Union. Our objective was to examine women's agency and how it related to desired timing of pregnancy among Romani women in Macedonia and Serbia. Methods We surveyed 410 Romani women who had given birth in the last 2 years between November 2012-February 2013 in Serbia and Macedonia using purposeful snowball sampling. Log-Poisson models were used to examine the association between women's inclusion in healthcare decision- making and desired timing of pregnancy. Results Romani women in Macedonia and Serbia were excluded from the labor market, with over 80% being unemployed, approximately 30% had no schooling, and 17% were not included in healthcare decisions. Romani women who were sole decision-makers in relation to their health were 1.4 times more likely to desire the timing of their most recent pregnancy [RRR = 1.4, CI (1.1, 1.8)]. Conclusions Romani women who have great involvement in their own healthcare decisions were more likely to desire the timing of their current pregnancy. Women's inclusion in such important decisions is important and empowerment programs that address gender inequity are needed in Romani communities, particularly for control of timing of pregnancy.
Aim:To examine the existing situation, barriers and consequences of the intercultural communication in health institutions and to offer training models for strengthening and improving communication skills of health professionals in the Republic of Macedonia.Methods:A cross-sectional survey was conducted to assess the relationship between patients and health professionals. A total of 813 health professionals (302 physicians and 511 other medical staff) from different healthcare institutions, and 1016 patients participated in cross-sectional survey performed in autumn 2010.Results:The research has showed that each third examined patient thought that his/her physician or the other medical personnel had no understanding for his/her emotions and gave no answer to all of his/her questions. From the other side, 60% of the physicians declare that they have a good communication with patients speaking other language than their mother tongue. Only 60% of physicians said that they know good the culture of their patient and 52% of the other medical staff said that they adjusted the treatment to the patient culture (religion, attitudes, language, life style).Conclusion:There are some gaps in current provision of health care practice in an aspect of effective interactions and communication skills of health professionals to meet patient needs in a multicultural and multilingual setting. A training model is proposed for strengthening communication skills of health professionals.
The aim of this paper is to assess the outcome and postinjury impact, analysing the data collected with the community-based injury survey conducted in Republic of Macedonia in 2008. WHO standard methodology has been applied on a nationally representative sample of 1200 households. The survey has recorded injury incidence rate of 5710/100 000 and mortality of 40/100 000. 75.2% of the reported injuries had not resulted in any physical disability. Most frequent physical disability is walk with a limp or difficulty using hand or arm; few reported inability to use hand or arm, loss of vision or inability to chew food. 46.4% of the victims were affected performing usual activities. 21.4% were not able to return to normal activities. Some of respondents stated losing their employment due to the injury. 31.2% reported losing days of work/school, on average 45 working days had been lost. There were also loss of work/school working days of a household member (7 days on average). 33.6% of injured reported decline in household income, while only one respondent stated a household member loss of employment due to taking care for the victim. This indicates that injuries and violence are serious public health problem that should be seriously considered for policy interventions. Prevention of injury and violence is set as on one of the priorities in the Health Strategy of the Republic of Macedonia 2008–2020.
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