Patient perspectives on the promptness and quality of care of road traffic incident victims in Peru: a cross-sectional, active surveillance study

Abstract

Background: Road injuries are the second-leading cause of disease and injury in the Andean region of South America. Adequate management of road traffic crash victims is important to prevent and reduce deaths and serious long-term injuries. Objective: To evaluate the promptness of health care services provided to those injured in road traffic incidents (RTIs) and the satisfaction with those services during the pre-hospital and hospital periods. Methods: We conducted a cross-sectional study with active surveillance to recruit participants in emergency departments at eight health care facilities in three Peruvian cities: a large metropolitan city (Lima) and two provincial cities (an urban center in the southern Andes and an urban center in the rainforest region), between August and September 2009. The main outcomes of interest were promptness of care, measured by time between injury and each service offered, as well as patient satisfaction measured by the Service Quality (SERVQUAL) survey. We explored the association between outcomes and city, type of health care facility (HCF), and type of provider. Results: We recruited 644 adults seeking care for RTIs. This active surveillance strategy yielded 34% more events than anticipated, suggesting under-reporting in traditional registries. Median response time between a RTI and any care at a HCF was 33 minutes overall and only 62% of participants received professional care during the initial “golden” hour after the RTI. After adjustment for various factors, there was strong evidence of higher global dissatisfaction levels among those receiving care at public HCFs compared to private ones (odds ratio (OR) 5.05, 95% confidence interval (CI) 1.88-13.54). This difference was not observed when provincial sites were compared to Lima (OR 1.41, 95% CI 0.42-4.70). Conclusions: Response time to RTIs was adequate overall, though a large proportion of RTI victims could have received more prompt care. Overall, dissatisfaction was high, mainly at public institutions indicating much need for improvements in service provision.

Analysis of Service Quality Gap between Perceptions and Expectations of Service Recipients using SERVQUAL Approach in Selected Hospitals in Golestan Province

“…In Tarrahi et al survey in health centers of Khoram Abad city in Iran, in expectations part, assurance and responsiveness had the maximum and minimum mean scores that were in line with the results of the present study. In the current investigation, regarding the patients' perceptions, reliability and responsiveness had the highest and lowest mean, respectively (31). In another study conducted by Bahadori et al in army hospitals, assurance and tangible dimensions were found to have the maximum and minimum mean score, which was not in line with the findings of the present study (32).…”

“…In another study conducted by Bahadori et al in army hospitals, assurance and tangible dimensions were found to have the maximum and minimum mean score, which was not in line with the findings of the present study (32). On the other hand, in a survey performed in Peru by Miranda et al (31) on people who suffered from traffic accident, assurance dimension was revealed to have the lowest mean. Moreover, despite the poor correlation in responsiveness dimension, the results showed correlations between five dimensions of service quality in the perceptions and expectations parts.…”

Avaliação da satisfação dos usuários atendidos por serviço pré-hospitalar móvel de urgência

“…Researches affirm that the transportation of the patient to the appropriate service directly influences his/her satisfaction with the service, thus providing continuity of care and its resolution 24, 25 . The transport of the patient to a hospital that presents problems of overcrowding may have influenced the negative evaluation of this indicator.…”

Measurement of Quality of Educational Hospital Services by the SERVQUAL Model: The Iranian Patients’ Perspective

“…Mustafa et al showed that, in hospitals in Egypt, patients’ expectations concerning the quality of the healthcare services were affected on their stratification from types of services and hospitals (public or private) (18). A study by Miranda and et al on 644 patients injured by vehicle accidents in Peru in 2013 indicated that 95% of patients in public hospitals and 78% of patients in private hospitals were dissatisfied with the quality of the healthcare services provided by these hospitals (19). Tabibi et al showed that there are significant differences between patients’ expectations and their perception of the actual quality of healthcare.…”