Quality of care in primary healthcare clinics in Winnipeg: A comparative study

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Parveen, Saila
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Background: The overall quality of care has been defined in terms of a set of seven core attributes taken from contemporary conceptual frameworks for assessing primary healthcare systems. Attributes are assessed using sub-attribute questions picked from previously developed and validated national level survey instruments. Data has been collected through structured questionnaire survey utilizing Likert items and scale to capture respondents’ perceptions of care. Both descriptive and nonparametric statistical methods have been used for data analysis. Information on demographic factors helped to understand the response patterns across different cohort groups. Key objectives: 1) To determine the perception of patients and physicians regarding the overall quality of care and its constituent elements delivered through the primary healthcare clinics in Winnipeg. 2) To compare the perceptions about different quality of care attributes as expressed by participating patients and physicians. Results: Both patients and physicians have positive views about the overall quality of care (median score >=4 on a 1-6 scale). Regarding individual attributes, “Interpersonal communication” and “Respectfulness” received the highest average score (5) and long-term health management received the lowest score (2). Patient and physician responses were found to be statistically different for access, comprehensiveness and long-term health management. The long wait time for seeing a doctor appeared to be a widely shared concern – only 43% of the patients urgently needing to see a doctor could get a same-day appointment; for non-urgent cases, less than 3% got a same-day appointment. Patients with higher educational levels appeared to be more critical about the quality of care; conversely, patients in good health rated the quality of care attributes more favourably. Conclusion: Patients and physicians are generally satisfied with the overall quality of care. However, patients have identified issues related to access, comprehensiveness of care and long-term health management. Patients concerns were found to be consistent with national level results. Long wait time was also flagged as a key concern. Primary healthcare clinics should proactively seek patient feedback to identify issues and improve their quality of service.
Quality of Healthcare, Primary care clinics, Patient perception, Survey, Healthcare attributes, nonparametric statistical methods