Factors associated with health service satisfaction among people living with HIV/AIDS: a cross sectional study at ART center in Chandigarh, India

Abstract

People living with HIV/AIDS (PLHA) while availing anti-retroviral therapy (ART) services face administrative and procedural problems in hospitals which affect their level of satisfaction with service providers. There is very little information available regarding quality of services provided at ART centers in India. Hence this study was conducted between July 2007 and December 2008 at ART Center, Chandigarh to analyse the user's perception about quality of services provided and factors associated with satisfaction level. For this prospective cross-sectional study, 100 PLHA were randomly recruited at ART Center. Exit interviews were conducted with structured questionnaire containing four groups of questions and questions on waiting time and satisfaction level. A scoring system was devised. The satisfaction level was cross matched with group questions. Mean age of 100 PLHA was 36.46 years (SD = 8.46), 22% were females, 55% from rural background and 67% educated above primary level. The mean group scores of four groups of questions were: Information, access and guidance (58.8%), Interaction with service providers (92.96%), Physical facilities (70.85%), Confidentiality, discrimination and grievance redressal (70.31%). Eighty-eight per cent rated satisfaction level as satisfactory or above (30% very satisfactory, 58% satisfactory), 10% indifferent and 2% dissatisfied. Factors found to be associated with satisfaction level were patient provider interaction (p=0.002) [behaviour of staff (p=0.005)], physical facilities (p=0.005) [cleanliness (0.002), drinking water (0.006)], confidentiality (p=0.004), waiting time to meet the doctor (p=0.03) and total time spent in hospital (p < 0.001). Problem areas identified were low availability of signage, low awareness of grievance redressal system, sanitation/toilets, drinking water, waiting time to meet the doctor (mean = 53.3 minutes), and “total time spent in hospital” (mean = 143 minutes). Study provided user's perspective about quality of ART services provided in a tertiary care hospital of India and revealed the factors associated with PLHA satisfaction level. Better quality ART Services can be provided to PLHA by addressing these factors.

Keywords:

• AIDS
• HIV
• satisfaction
• ART
• India

Acknowledgements

We sincerely thank the participants for their time and energy in sharing their views and experiences; and staff member of ART center for their cooperation especially Dr Archna B. Mohan & Dr Neeru Sharma. We gratefully acknowledge the technical and statistical inputs of Shivi Negi and Dr P. K. Gupta. We are thankful to Dr Ritu Nehra for helping in preparation of questionnaire.