Abstract

Background: The satisfaction of patients and their families who seek care at health institutions are influenced by several circumstances. Therefore, correctly identifying the determinants of patient satisfaction is crucial for designing effective improvement methods. A holistic evaluation of patients’ experiences across various hospitals, particularly tertiary hospitals in Ghana, has not been achieved yet; hence the need for this study in the Korle Bu Teaching Hospital. (KBTH) This article seeks to evaluate the trends and determinants of client satisfaction with the quality of care they receive across healthcare facilities in Korle Bu Teaching Hospital. This may give us an idea as to the picture of client satisfaction experience countrywide using KBTH as a case study.
Methods: This is a quantitative exploratory study design conducted between the years 2021 and 2024 at the KBTH in Accra, Ghana. We included 10,986 respondents aged 18 years and above who accessed care and relatives of patients/clients who assisted/supported them during the process. The analysis was conducted using stata version 17. Descriptive, chi-square, and multilevel regression analyses were performed. Frequencies, percentages, and odds ratios (ORs) with corresponding 95% confidence intervals (CI) and p-values were used to present the results.
Results: We found that the trend of the level of satisfaction among clients in the KBTH increased from 55.83% in 2021 to 79.02% in 2023; however, it dropped to 51.09% in 2024. The overall satisfaction among clients was 63.1%. We found that respondents aged 38-47 [aOR=1.49, 95% CI=1.16-1.91], females [aOR=1.16, 95% CI=1.06-1.27], the Dietherapy Department [aOR=2.97, 95% CI=1.82-5.84], outpatients [aOR=1.48, 95% CI=1.31-1.66], and the 2024 survey year [aOR=2.49, 95% CI=1.87-3.30] had higher odds of satisfaction. However, clients/respondents with tertiary education [aOR=0.61, 95% CI=0.47-0.77], were cohabiting women [aOR=0.63, 95% CI=0.45-0.88], working in the informal sector [aOR=0.79, 95% CI=0.71-0.89], were relatives of patients [aOR=0.83, 95% CI=0.75-0.91], and patients who were not first-time visitors [aOR=0.83, 95% CI=0.75-0.91] had lower odds of satisfaction.
Conclusion: This study assessed the trends and determinants of clients (patients and relatives) satisfaction in the largest teaching hospital in West Africa over a four-year period. The level of client satisfaction in 2024 declined and was lower than the 2021 value. The main determinants of client satisfaction as identified by the study were: age, gender, patient status, education and marital status. Health facilities should therefore be guided by these in designing their services and ensure that clients get the required satisfaction at every encounter. Finally, it is also very evident that clients know when they are satisfied or otherwise, hence health facilities will have to create opportunities to involve them in the design of health services to ensure these are mutually beneficial.