TITLE

Increasing Access to Government Primary Care Health Facilities: Quality Improvements Matter

AUTHOR(S)
Antonio, Carl Abelardo T.
PUB. DATE
June 2014
SOURCE
Australian Journal of Basic & Applied Sciences;2014 Special, Vol. 8 Issue 8, p38
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Context - Government health facilities, which primarily cater to the poorer segments of a community, have a reputation for providing low-quality services. This results to low utilization of the facility, thereby exacerbating further inequities in healthcare. This paper reports on the results of a facility-level intervention to improve quality of care in a government primary care facility in a highly-urbanized city in the Philippines. Objective -To determine if there is a significant difference in the mean number of patients seen before and after implementing an intervention in a local health facility in a highly-urbanized city in the Philippines. Methodology -Facility N is a primary care facility owned and operated by a local government unit in a highly-urbanized city in the Philippines. Its catchment area is comprised of 11 barangays (villages) with an estimated population of 22,624. A three-pronged intervention to improve quality of service delivery was implemented consisting of a) staff demonstration of courtesy to patients, b) efficient case management, and c) consistency of service availability. Controlling for the day of the week, mean monthly patient case loads before the intervention (T0), and at one (T1), two (T2), three (T3), and four (T4) months post-intervention were compared using analysis of variance to determine if there is a significant differencein the number of patients seen before and after implementing the intervention at the 0.05 level of significance. This was supplemented with focus groups conducted among community representatives. Data was collected from August to December 2012, and analyzed in February 2013. Results -Mean (±standard deviation) patient case load increased over the study periods [T1 = 46 (±16), T2 = 45 (±20), T3 = 50 (±22) , and T4 = 36 (±21) ] compared to pre-intervention levels [ T0 = 34 (±17)]. Two-way analysis of variance showed that there is a difference in the mean number of patients seen in at least one time periods (p <0.001). Further analysis using Fisher-Hayter Pairwise comparison showed significant mean difference between T0 and T3 only. In the focus groups conducted among community representatives (government officials, housewives, lay health workers) before and at four months post-intervention, respondents noted the positive reception by community members of improvements being implemented in the health facility. Conclusion -Quality improvements in service delivery, especially in government facilities, are essential in expanding access to the health system, bridging the gap in health status between the poor and non-poor, and achieving the goal of universal health care.
ACCESSION #
96793555

 

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