Goal of research: To identify the changes in the level of population's with the different components of the quality of medical care.
Empirical base of research:
Population surveys commissioned by the HSE and implemented by the Levada Center in September 2013 and in September-October 2014 with the samples of size 3302 and 4503 respondents respectively representing adult (16 years and older) population of the Russian Federation.
Results of Research:
The structure of different socio-demographic group’s attitudes towards health problems is characterized by a high degree of stability. There is prevailing of positive assessments of changes in the hospitals and clinics that have occurred during the year prior to the survey: 42% of respondents believe that their work is more improved, and 29% - see the deterioration. At the same time, those who in the past year had personal experience of health services, some more likely to report a deterioration in work (32%) than those who did not seek medical care in the past year (19%).
Nearly two-thirds of the adult population believe that the professional level of the majority of doctors in Russia is lower than required (58%) and doctors are more concerned about their income than about the patient (60%). These estimates indicate a deficit of public trust in the doctors and the Russian health care system.
The relative importance of different areas to improve the quality of health care, according to the population assessment, remains stable: the most important is a more conscientious attitude of medical staff to their duties, and the significance of this area is even slightly increased over the last year. The improvement of drug supply in hospitals and improvement of health care facilities and ambulance crews equipment are next in importance.
The survey data confirmed that the majority of Russian patients is treated free of charge.
Most of the surveyed patients (78%) expressed satisfaction with the quality of outpatient care received in the last case of applying for it. However, a comparison with a data of the similar survey in 2013 and the All-Russian population survey for assessing the quality and accessibility of health care, conducted by Roszdravnadzor in 2009, has shown the slow decline in satisfaction with the results of outpatient care and with the attitude of physicians to patients. The satisfaction with the results of dental care is highest - about 93% of patients were in favor. The difference in the estimates of the results of dental care as compared to the survey in 2013 is virtually absent. The same high level of satisfaction demonstrated patients who underwent diagnostic studies: 9 out of 10 respondents were satisfied with the result. The satisfaction with inpatient care is quite high: the 82% of respondents were satisfied with her. A comparison with the surveys in 2009 and 2013 shows the retention in 2014 of the trend of decrease in satisfaction with the results of inpatient care and satisfaction with the attitude of physicians to patients. The satisfaction with ambulance services is on the same high level as in 2013 - 83% of respondents were satisfied with the service.
The proportion of respondents who want to re-apply at the same medical facility, correlates, comparing different types of health care, with the proportion of respondents who report a lack of choice of medical facilities. This is a strong argument in favor of positive effect of competition among health care providers on quality of care.
In assessing the relative importance of the quality of medical services and their territorial accessibility for patients, more than half the population (55%) were in favor of the quality of care, even if for the sake of receiving it patients have to go in a fairly remote areas or towns. Territorial accessibility was important for 38% of respondents. The only category of the population for whom access to health care was more important than quality, are retired (47% vs. 44%).
Level of implementation, recommendations on implementation or outcomes of the implementation of Results:
The results of the population survey can be used to precise the priorities of public policy on improvement the quality of medical care.
Field of application: health care system.