--- RESEARCH PROJECT (BMBR5103) WHAT FACTORS OF DRUG DISTRIBUTION SYSTEM AFFECT THE SATISFACTION OF OUTPATIENT WITH HEALTH INSURANCE AT DISTRICT 2 HOSPITAL? STUDENT’S FULL NAME : BUI ANH VU STUDENT ID : CGS00064957 INTAKE : MARCH, 2016 ADVISOR’S NAME & TITLE : ASSOC. BUI PHI HUNG August, 2017 --- Advisor’s assessment. Advisor’s signature --- EXECUTIVE SUMMARY Improving the quality of patient care is always the highest goal of the health sector. Especially in recent years, the policy for socialization of health care has facilitated a wide range of medical services, the competition has contributed to boosting the demand for service quality improvement.
The drug distribution system has been considered the most important and the most costly component of any health system and therefore it affects significantly the overall quality of health care. As a result, evaluating the quality of this system is a vital part of the process of improving both the quality and efficiency of health care. Patient satisfaction is the "property" of hospital. The patient satisfaction index is the criterion used to measure the response of health facilities to the expectations of patients.
In other words, patient satisfaction is the highest measure of the quality of the operation of health facilities, not other forms of honor Program 527/CTr-BYT (June 18, 2009) of the Ministry of Health on "Improving the quality of medical examination and treatment at medical facilities for the purpose of meeting the patient satisfaction with the health insurance" require: improve morale, patient service attitude; reform administrative procedures; reduce inconvenience in reception, medical examination, treatment and payment to patients; improve the quality of health services in hospitals and healthcare facilities; ensure the rights of patients with health insurance, avoid abusing medicine, technology and test in order to save health resources and costs (Ministry of Health, 2009). In addition, Ministry of Health Circular No. 19/2013/TT-BYT dated July 12, 2013 guiding implementation of medical service quality management requires all hospitals to assess the effectiveness of criteria, standard and quality management model indicators by 2018 (Ministry of Heath, 2013). Medicine supply is one of the important tasks that affect the quality of hospital treatment and is also a significant factor in assessing the quality of pharmacy's department.
--- In fact, the distribution of drugs has many factors affecting to patient satisfaction such as: drug quality, drug delivery process, waiting time, medicine consultation. Therefore, it is necessary to have sufficient research to find out what factors make the patient dissatisfied. In Vietnam, the issue of drug supply in hospitals still exist many inadequacies and receive social attention. This inadequacy can occur at all stages of the drug delivery process: from procurement to delivery, from prescription to instructional use.
Despite continuous efforts, the health sector has not yet met the needs and expectations of patients. There is always a gap between the current response and demand. In order to measure and narrow this gap, the quality of drug supply and quality improvement work needs to be concentrated on the basis of a highly relevant assessment of patients. When the Health Insurance Law came into force on July 1, 2009, District 2 Hospital in Ho Chi Minh City became the place of registration for primary healthcare for patients with health insurance.
As a result, the number of outpatient with health insurance has increased from 800 to 1000 patients per day, leading to overload in some departments, especially in drug distribution system. Therefore, the topic "What factors of drug distribution system affect the satisfaction of outpatient with health insurance at District 2 Hospital ? " be done. Overall objective: Providing factors of medicine dilivery activities affecting patient satisfaction. Describe and explain how each factor influence patient satisfaction.
Find out which factors actually impact patient satisfaction 3. Provide recommendation to improve the quality of drug distribution system. --- CONTENTS CHAPTER 1 - INTRODUCTION. Context and Relevance.
Scope of research. 6 CHAPTER 2 - LITERATURE REVIEW. What is the drug distribution system?. What is patient satisfaction?.
What factors may affect patient satisfaction?. How to measure patient satisfaction?. Gap in liturature. 22 CHAPTER 4 - FINDINGS - DISCUSSION.
Descripting and explaining each factor. The purpose of the research. Addressing the research question. Limitation and Recommendation.
Answering the Research question. Introduction In this chapter, I will introduce the research, overview District 2 Hospital, outline the aims and discuss why it is relevant to quality of healthcare in Vietnam. It will briefly measure the circumstance of the research and present the structure for this dissertation. Firstly, I will sketch some highight of public hospitals in Vietnam and overview of District 2 Hospital.
Then we will discuss the study aims and this will help us to develop a focused research question to investigate. It will then state how this research is important and the relevance to the quality of healthcare in Vietnam. Following which it will highlight what this dissertation will examine and the confines of it. Finally it will finish by outlining the structure for the rest of the research.
Public hospitals play a crucial role in the healthcare system in Vietnam because they are the dominant provider of hospital care compared with private hospitals. Among 1,099 hospitals national wide, there are 962 public hospitals, accounting for 87.5 per cent of the whole hospital system (Vietnam General Statistics Office, 2012). As a result, evaluating the quality of drug distribution system would help to better understand the current supply capacity and quality of supply and significantly contribute to the aim of improving the health outcomes for people in Vietnam.0 District 2 Hospital District 2 Hospital was built in 1998 with the initial size of only 60 beds, but with the support of the state, District 2 Hospital has been raised to 150 beds since 2015. Besides upgrading advanced medical equipment and facilities, District 2 Hospital may also pay much attention to improving the level of medical staff, working principles, behaviors for physicians, nurses, technicians through training.
With a better goal of serving, the board of directors, doctors and nurses have been constantly innovating and improving their capacity. Since 2015, District 2 Hospital has attracted from 1,000 to 1,100 outpatients to medical examination and treatment every day, 2.5 times higher than in 2014. The number of inpatients has also increased, beds were always filled with over 90% patients. The rate of referral to upper levels in 2015 decreased by 72% compared to 2014.
In the first six months of 2017, the hospital has reduced the rate of referral to higher levels up to 82% 2 --- over the same period in 2016 due to technical advances, actually hospital currently owned about 650 complicatied techniques. People now are gradually becoming more confident in the quality of medical examination and treatment of hospitals and this has contributed significantly to reducing the overload of such hospitals: Cho Ray, Binh Dan, Nhan Dan Gia Dinh,. Research Aims This research aims to define what factors of drug distribution system affect outpatient satisfaction at District 2 Hospital. Based on these factors, managers can find solutions to improve the efficiency of drug distribution system and enhance the quality of healthcare in their hospital.
Research Question A research question is the core of a research, the overall purpose of the research is therefore to find an answer to the research question. In this instance, the research question should be tightly focussed, that is, it should be extremely clear exactly what aspect of practice the researcher is investigating and with which population of patients or clients. So the study was conducted to answer the following research questions: - What factors of drug distribution system affect the satisfaction of outpatient with health insurance at District 2 Hospital? - Why/How these factors affect the quality of drug distribution system at District 2 Hospital? 1. Context and Relevance The Vietnamese public hospital system is overloaded, especially at the provincial and national levels, both in general and specialty public hospitals.
Further, the current shortage of experienced medical doctors, pharmacist and other professional staff has put 3 --- increasing burden on hospital capacity to meet healthcare needs of the population. This situation therefore affects the quality of healthcare system (Le TP, 2014). 68/QD-TTg dated January 10, 2014 of the Prime Minister approving the National Strategy on Vietnam pharmaceutical industry’s development to 2020 and with the vision to 2030. The overal objectives is to supply medicines adequately, timely with quality and rational prices according to the disease structure respectively with each socio-economical development stage and ensure medicine usage to be safe and rational.
To attach special importance to medicine supply for subjects belonging to social. The current drug distribution model illustrates a complicated process can influence the quality of drug distribution system that is expressed by patient satisfaction. Over the past 20 years, patient satisfaction surveys have gained increasing attention as meaningful and essential sources of information for identifying gaps and developing an effective action plan for quality improvement in healthcare organizations. However the application of these findings is not the same in each healthcare center.
Each hospital should conduct its own patient satisfaction studies in order to improve the quality of healthcare. Why I choose District 2 Hospital? District 2 Hospital is a secondary hospital undercontrolled by Ho Chi Minh City Ministry of Health. In the past, there was no systematic study to evaluate customer satisfaction about the quality of drug distribution system for outpatients at District 2 Hospital. A number of surveys have been conducted at other hospitals, however, those research could not apply to enhance the quality of healthcare for this hospital.
Therefore a systematic study is needed to discover and answer the research questions posed. Scope of research The research involves the concepts of service quality in general and quality of drug distribution system in particular. Quality of drug distribution system perceived by 4 --- patients has been considered the transformation of the most frequently-used term: patient satisfaction. The results of the research will provide evidence-based suggestions for applying the framework to identify factors affecting to patient satisfaction in Vietnam, contributing to assess and improve the service quality of the drug distribution system in general and of District 2 Hospital in particular.
Due to time restraints, the sample will be limited to 174 participants. This may mean that the results cannot be generalised to the whole population. Due to limited time and budget, the research will ask participants to self evaluate their satisfaction levels and therefore it may have poor construct validity. Structure The next chapters of the thesis will address the intellectual and organisational context of the thesis.
In Chapter 2, a critical literature review will focus on the fundamental issues of drug distribution systems in general and District 2 Hospital within the drug distribution system in Vietnam. The basic concepts of service quality and current models of quality management will be presented before concentrating on the conception of satisfaction in the context of patients’ perception on quality of hospital care. Chapter 3 will detail the study methodology, target population, instruments used, and the procedures of analysing the quantitative data. The findings and the discussion will then be presented using tables and graphs to highlight the key points found.
Averages and correlations will be calculated to help form an answer to the research question. Each high-light will be explained and discussed what has been found and to relate it back to the existing literature. This will allow the researcher to draw conclusions from the data. Conclusion This chapter has introduced the research and discuss the aims and relevance of it.
It has outlined the scope of the research and created a research question that can be investigated. The next chapter will present existing literature surrounding the question “What factors of drug distribution system affect the satisfaction of outpatient with health insurance at District 2 Hospital ?” This will give background knowledge for the topic and will be informative about what has previously been investigated.