Satisfaction with Health Care Services: A Survey … · 2014. 3. 11. · Health Services, the health professions and providers as well as other stakeholders responsible for health

What were some of the key findings?

The following are some of the key findings Albertans

identified from their experience with the health care system.

Results reflect Albertans’ experiences between March 2007

and May 2008.

60% OF THOSE WHO RECEIVED HEALTH CARE SERVICES IN ALBERTA IN

THE PAST YEAR RATED THEIR SATISFACTION AS 4 OR 5 OUT OF 5,

A STATISTICALLY SIGNIFICANT IMPROVEMENT FROM 58% IN 2006

AND 52% IN 2004.

46% OF THOSE RESPONDENTS WHO USED THE SYSTEM FOUND IT EASY

OR VERY EASY (4 OR 5 OUT OF 5) TO ACCESS HEALTH CARE SERVICES.

THIS IS UNCHANGED FROM 47% IN 2006 AND 46% IN 2004 AND

UP FROM 44% IN 2003.

83% OF RESPONDENTS WHO HAVE A PERSONAL FAMILY DOCTOR ARE

SATISFIED WITH THE SERVICES THEY RECEIVED. THIS IS UNCHANGED

FROM 84% IN 2006 AND 2004.

42% REPORTED THEIR FAMILY DOCTOR WAS LOCATED IN A NON-

TRADITIONAL SETTING (A SHARED OFFICE OR MULTI-DISCIPLINARY

PRACTICE).

31% OF PATIENTS (WITH A FAMILY DOCTOR) HAD AN URGENT BUT MINOR

PROBLEM WHEN THEIR DOCTOR’S OFFICE WAS CLOSED. OF THE

31%, 59% WENT TO AN EMERGENCY DEPARTMENT FOR THE CARE

THEY REQUIRED.

58% WERE SATISFIED OR VERY SATISFIED WITH THE EMERGENCY

DEPARTMENT SERVICES THEY OR A CLOSE FAMILY MEMBER RECEIVED.

THIS IS UP FROM 51% IN 2006 AND 50% IN 2004 AND 2003.

52% OF THOSE RESPONDENTS WHO VISITED AN EMERGENCY

DEPARTMENT (ED) WENT TO THE ED INSTEAD OF SOMEWHERE ELSE

BECAUSE IT WAS THE ONLY CHOICE AVAILABLE AT THE TIME.

HOWEVER, 10% OF RESPONDENTS SAID THEY LEFT BEFORE THEIR

CARE AND TREATMENT WAS COMPLETED.

81% OF RESPONDENTS WERE SATISFIED OR VERY SATISFIED WITH HEALTH

CARE SERVICES RECEIVED FROM THEIR SPECIALIST. THIS IS UNCHANGED

FROM 2006 BUT UP FROM 74% IN 2004 AND 70% IN 2003.

10% OF RESPONDENTS REPORTED EXPERIENCING UNEXPECTED HARM,

DOWN FROM 13% IN 2006. IF UNEXPECTED HARM DID OCCUR, 34%

REPORTED THEY WERE TOLD BY THEIR HEALTH CARE PROVIDER.

THIS IS DOWN FROM 40% IN 2006.

62% OF THOSE THAT HAD A COMPLAINT WERE EITHER DISSATISFIED OR

VERY DISSATISFIED WITH HOW THEIR COMPLAINT WAS HANDLED.

Why did we do the survey?

In 2003, the Health Quality Council of Alberta (HQCA)

released the results of its first Satisfaction with Health Care

Services: A Survey of Albertans. The population-based survey

looked at Albertans’ perceptions of and actual experiences

with overall quality, satisfaction and access with specific

health services. We conducted similar surveys in 2004,

2006 and 2008.

Our 2008 survey again measures satisfaction with health

care services through the eyes of Albertans and identifies

areas of success and those that need improvement. Where

possible, it also compares 2008 results with those from

previous years. Changes to the 2008 survey included

expanded sections on primary care and emergency

departments as well as new questions about hand hygiene,

preventative care and the patient’s role in health care.

What did we want to learn?

Survey information is critical to identify what Albertans

believe are priority areas affecting the quality, safety and

performance of the publicly funded health care system.

It also informs Alberta Health and Wellness, Alberta

Health Services, the health professions and providers as

well as other stakeholders responsible for health care service

delivery about those issues most important to Albertans.

As the 2008 survey was conducted prior to amalgamation

of Alberta’s former nine health regions, the results may

also provide a baseline for measuring future quality

improvements under the new organizational structure.

How did we do the survey?

Population Research Laboratory at the University of

Alberta conducted the 2008 survey. They did 4,302

telephone interviews with Albertans aged 18 years and

older between March 10 and May 27, 2008. Interviews were

stratified by the nine provincial health regions. The margin

of error for the province was ±1.5%, 19 times out of 20.

Satisfaction with Health Care Services: A Survey of Albertans 2008

WWW.HQCA.CA

JULY 2009

PROMOTING AND IMPROVING PATIENT SAFETY AND HEALTH SERVICE QUALITY ACROSS ALBERTA1

Overall satisfaction with specific health services

2008 2006 2004 2003HEALTH CARE SERVICE AREA (% SATISFIED)** (% SATISFIED)** (% SATISFIED)** (% SATISFIED)**

FAMILY DOCTOR* 83 84 84 81

COMMUNITY WALK-IN CLINICS* 56 57 59 55

EMERGENCY DEPARTMENT* 58 51 50 50

SPECIALIST CARE 81 81 74 70

MENTAL HEALTH 74 72 70 N/A

MRI* 89 79 N/A N/A

DIAGNOSTIC IMAGING* 89 88 N/A N/A

LABORATORY TESTS* 91 85 86 N/A

PHYSIOTHERAPY 78 74 N/A N/A

HEALTH LINK 73 78 77 N/A

SERIOUS COMPLAINT HANDLING* 19 24 15 21

*Denotes statistically significant change **% satisfied (4 and 5 out of 5) N/A denotes a new or revised question or trending not available



What do Albertans say about quality ofhealth care services?

There is a growing gap between Albertans’ general

perceptions of the quality of the health care system and

their ratings of quality based on actual services received.

Based on perceptions of the system, 60% of those surveyed

believe the quality of health care services in the province

is excellent or good. 73% of those who have actually

received services in the past year rate the quality of those

services as excellent or good. This represents a 13%

difference between perception and actual experience and

a gap that has widened from 11% in 2006.

Are Albertans satisfied with the servicesthey receive?

The percentage of Albertans satisfied with the health care

services they received in the past year has increased

significantly over time. Four of the nine former health

regions show significantly higher satisfaction levels over

time since 2003.

From the public’s perspective, access – the ease of obtaining

health care services – continues to be by far the most

important factor associated with their overall satisfaction

with health care services received. In addition to access to

health care services, other priority themes emerge as

associated with Albertans’ overall satisfaction with health

care services received.

• Satisfaction with family doctors – survey respondentswho were satisfied or very satisfied with their familydoctor were nearly twice as likely to report overall satisfaction with health care services received.

• Ease of finding a personal family doctor or practice– those who reported it was easy or very easy to find their personal family doctor were 57% more likely to report overall satisfaction with health care services received.

Factors associated with dissatisfaction include:

• Having a serious complaint about health careservices received

• Dissatisfied or very dissatisfied with specialist services

• Dissatisfied or very dissatisfied with servicesreceived from a personal family doctor

Ease of access to specific health services

2008 2006 2004 2003HEALTH CARE SERVICE AREA (% EASY TO ACCESS)** (% EASY TO ACCESS)** (% EASY TO ACCESS)** (% EASY TO ACCESS)**

FAMILY DOCTOR* 73 74 N/A N/A

COMMUNITY WALK-IN CLINICS* 53 60 60 54

EMERGENCY DEPARTMENT* 51 48 50 46

SPECIALISTS* 59 56 47 42

MENTAL HEALTH* 79 74 66 N/A

PHYSIOTHERAPY* 86 76 N/A N/A

MRI 59 56 N/A N/A

LABORATORY TESTS 88 86 86 N/A

DIAGNOSTIC IMAGING* 79 92 N/A N/A

*Denotes statistically significant change **% easy (4 and 5 out of 5) N/A denotes a new or revised question or trending not available



Access remains by far the most important factor associated

with Albertans’ overall satisfaction with health care services

received in the province. 46% of those surveyed in 2008

rated access to health care services as easy or very easy

(4 or 5 out of 5). This is relatively unchanged over time

(2006: 48%; 2004: 47%; 2003: 44%). However, those rating

access as very difficult/difficult (1 or 2 out of 2) has

increased over time. In 2008, that number rose to 30%, up

from 26% in 2006, 25% in 2004 and 24% in 2003.

Ease of obtaining service from their family doctor is the

factor most strongly associated with overall ease of access

to health care services. Other factors associated with ease

of access to health care services include:

• Ease of access to hospital services

• Ease of access to specialist services

• Excellent or very good coordination by healthprofessionals to serve patient needs

Factors associated with difficulty in overall access to

health care services are:

• Difficulty obtaining service from family doctors

• Difficulty accessing hospital services

What do Albertans say about access to health care services?



In Brief…

FAMILY DOCTORS

• 81% of those surveyed currently have a family doctor;this is unchanged from 2006.

• 42% identified their doctor as being in a non-traditionalsetting (shared office or clinic where they could see a doctor other than their personal family doctor or some other health care professional such as a nurse).This may reflect an increasing proportion of shared and multi-disciplinary practices and the emergence of primary care networks in Alberta.

• Of those respondents who had a family doctor andindicated they needed care for an urgent but minor condition when their family doctor’s office was open,66% were able to get an appointment as soon as they needed it.

• Of those who had a family doctor and said theyrequired care for an urgent but minor condition whentheir family doctor’s office was closed, 59% went to anemergency department, 34% went to a walk-in clinicand 5% made an appointment when their family doctor’s office was open.

• For those who reported they did not have a personalfamily doctor, 38% said it was because the family doctors were not taking new patients or their familydoctor had left or retired. 58% said they go to a community walk-in clinic when they need care usuallyprovided by a family doctor.

• Family doctors in non-traditional (shared or multi-disciplinary settings) perform as well or sometimes better than those in traditional practice settings for a majority of specific service attributes.

PATIENT’S ROLE & RESPONSIBILITY

• 73% of those surveyed said they almost always oralways asked the doctor all of their questions.

• 48% said they kept a list of their current medications.Of that 48%, 85% said they always share the list withtheir health care provider.

• 66% said their family doctor definitely had theinformation, skills and knowledge to manage their health issues.

PREVENTION

• 37% of those surveyed said they needed their doctor’shelp in making changes to prevent illness. Of those that said they did need help, 93% said their doctor gave them the help they needed.

• 46% said they and their doctor had talked about ahealthy diet and eating habits.

• 58% had spoken with their doctor about their physicalexercise or activity.

• 31% said their doctor asked them whether there wasa period of time when they felt sad, empty or depressed.

• 65% reported their doctor encouraged them to talkabout all of their health concerns.

COMMUNITY WALK-IN CLINICS

• 53% reported it was easy or very easy to obtain healthcare services from a walk-in clinic. This is down from 60% in 2006 and 2004.

• Of those that visited a walk-in clinic, 52% said theywent because they needed medical attention right away. This is up from 49% in 2006.

• Satisfaction with services received from a walk-in clinichas not changed between 2008 (56%) and 2003 (55%).

• 65% of respondents who visited a walk-in clinic weresatisfied or very satisfied with the ultimate impact the care received had on their health and lives. This has improved significantly since 2003 (49%).

EMERGENCY DEPARTMENT (ED) SERVICES

• 51% of those that visited an ED reported it was easyor very easy to get ED services. This is a significant increase from 46% in 2003 but only a small increase from 50% in 2004 and 48% in 2006.

• 52% of those respondents that visited an ED said theywent to the ED instead of somewhere else because it was the only choice available at the time. 35% saidit was the best place for their medical problem, 20% said it was the most convenient place to go and 20%said they were told to go to the ED.



• 59% of those surveyed said a staff member checkedon them while they were waiting. Of these, 48% reported they were checked on every 15 minutes, 25% once every half hour, 14% once every hour and5% less often than once every two hours.

• 10% of respondents said they left the ED before careand treatment was completed. Those that are more likely to leave or consider leaving the ED before treatment were those 25 to 44 years old and those who could not get a staff member to help if needed.

PUBLIC HEALTH

• 51% of those surveyed were not concerned aboutcatching an infection at a hospital, clinic or doctor’s office.

• 78% said they always washed their hands when theysaw signs or posters about hand washing; 17% reported they sometimes washed their hands and 6% said they did not wash their hands.

• 89% saw health care workers either put on new glovesor wash their hands before they touched or treated them. 11% said they did not see this occur.

MENTAL HEALTH SERVICES

• 74% of those respondents who obtained mental healthservices in the past year reported they were satisfied or very satisfied with the services they received. This is up slightly from 72% in 2006 and 70% in 2004.

• 79% of those surveyed reported obtaining mentalhealth services was easy or very easy compared to 74% in 2006 and 66% in 2004.

SPECIALIST SERVICES

• 59% of those surveyed said it was easy or very easyto obtain specialist services, up from 56% in 2006, 47% in 2004 and 42% in 2003.

• There has been little change in satisfaction with theamount of time respondents had to wait after bookingan appointment to see the specialist (2008: 54%; 2006: 52%).

2008 2006 2004 2003(%) (%) (%) (%)

EXCELLENT, VERY GOOD

OR GOOD 83 82 84 85

FAIR OR POOR 17 19 16 15

HEALTH LINK

• 71% of those surveyed were aware of Health Link,up from 66% in 2006 and 63% in 2004.

• Of those who were aware of Health Link, 33% saidthey had called Health Link, down from 39% in 2006 and 35% in 2004.

• 73% of those that had called Health Link in the pastyear were very satisfied or satisfied with the experience. This is down from 78% in 2008 and 77% in 2006.

• 81% of those surveyed in 2008 said they were satisfiedor very satisfied with the ultimate impact their specialist’s care had upon their health and lifecompared to 65% in 2003.

• All attributes (e.g., treating patients with courtesy

and respect, spending enough time with patients,

specialist’s knowledge and competence) continued to

improve and showed high satisfaction ratings in 2008.

COORDINATION OF CARE

• Regardless of survey year, respondents typically feltthe coordination of health care professionals to servetheir needs was good.

PATIENT SAFETY

• 10% of respondents indicated they or an immediatefamily member had experienced unexpected harm while receiving health care in Alberta in the past year. This is down from 13% in 2006.

• 51% of those who experienced unexpected harm saidthe harm occurred in hospital as an inpatient.

• 34% reported they were told by their health care professional that unexpected harm had occurred. This is down from 40% in 2006.



COMPLAINTS

• 13% of those surveyed had a serious complaint abouthealth care services received. This is relatively unchanged from previous years (2006: 14%; 2004: 15%; 2003: 15%).

• Of those who had a complaint about health servicesin 2008, 70% told someone about their complaint.

• 62% of respondents were either dissatisfied or very

dissatisfied with how their complaint was handled.

Summary of satisfaction and access scores by health region

OVERALL OVERALL OVERALL FAMILY WALK-INQUALITY* ACCESS SATISFACTION DOCTORS CLINICS

ALBERTA

1. CHINOOK

2. PALLISER

3. CALGARY

4. DAVID THOMPSON

5. EAST CENTRAL

6. CAPITAL

7. ASPEN

8. PEACE COUNTRY

9. NORTHERN LIGHTS

% Easy access 46 73 53

% Satisfied 74* 60 83 56


% Satisfied 77* 67 85 69


% Satisfied 80* 63 84 63


% Satisfied 71* 57 84 50


% Satisfied 76* 61 86 71


% Satisfied 79* 67 87 73


% Satisfied 75* 62 81 56


% Satisfied 78* 69 87 64


% Satisfied 66* 53 82 62


% Satisfied 54* 40 63 56

*Percentage total of good/excellent ratings

Note: small sample sizes for all health regions except Capital and Calgary result in a large margin of error that may be greater than the variation betweenregions. See technical report for specific detail.



Summary of other ratings across health regions

UNEXPECTED HARM SERIOUS COMPLAINT COORDINATION OF CARE HEALTH LINK(% EXPERIENCING) (% YES) (% EXCELLENT/VERY GOOD) (% AWARE)

ALBERTA 10 13 49 71

1. CHINOOK 11 14 53 61

2. PALLISER 9 10 49 67

3. CALGARY 10 14 49 70

4. DAVID THOMPSON 10 11 51 69

5. EAST CENTRAL 8 11 57 71

6. CAPITAL 11 13 48 77

7. ASPEN 10 11 55 68

8. PEACE COUNTRY 7 14 46 71

9. NORTHERN LIGHTS 8 16 31 68

SPECIALIST DIAGNOSTICED SERVICES SERVICES LAB TESTS IMAGING

ALBERTA

1. CHINOOK

2. PALLISER

3. CALGARY

4. DAVID THOMPSON

5. EAST CENTRAL

6. CAPITAL

7. ASPEN

8. PEACE COUNTRY

9. NORTHERN LIGHTS

% Easy access 51 59 88 79

% Satisfied 58 81 91 89


% Satisfied 63 81 91 90


% Satisfied 60 82 94 85


% Satisfied 58 80 90 90


% Satisfied 62 79 92 85


% Satisfied 69 83 94 93


% Satisfied 53 82 91 89


% Satisfied 69 81 95 92


% Satisfied 56 87 93 92


% Satisfied 40 80 84 78

Note: small sample sizes for all health regions except Capital and Calgary result in a large margin of error that may be greater than the variation betweenregions. See technical report for specific detail.


What happens next?

The HQCA did this survey to get information to help

Alberta Health Services, Alberta Health and Wellness,

health professionals and providers as well as other

stakeholders improve the quality and safety of the health

care system. We gave a detailed report to these groups so

they can see where Albertans say the health care system

is working well and where it can be improved. Our next

step is to encourage stakeholders to use the survey findings

to achieve improvements in quality of care for Albertans.

As a result of previous survey findings, in 2008 we released

the results of surveys that targeted specific service areas:

Emergency Department Patient Experience Survey and Long Term

Care Resident and Family Experience Surveys.

With the 2008 survey complete, the HQCA will again

consult with stakeholders to determine provincewide

quality improvement initiatives.

Tell us what you think

Please take a moment to answer the following questions. You may also do this online at www.hqca.ca.

1. How did you hear about Satisfaction with Health Care Services: A Survey of Albertans 2008?

2. Did you find the information useful? Yes No

3. How could we improve future publications?

4. What other topics would you like to see the HQCA focus on?

5. Other comments?

Fax your comments to us at 403.297.8258 or mail to: Health Quality Council of Alberta 210, 811-14 Street NW

Calgary, AB T2N 2A4 Thank you for completing and returning this survey.


Acknowledgements The HQCA thanks those Albertans who participated in this survey.

Want more details about the survey? For a copy of the technical report go to www.hqca.ca.

Documents

Satisfaction with Health Care Services: A Survey … · 2014. 3. 11. · Health Services, the health professions and providers as well as other stakeholders responsible for health