III Biannual International Conference on the Future of Primary
Care in Europe
Patients’ rights thruogh their
eyes in public health
institutions in Serbia
Institute of Public Health of Serbia
Mirjana Živković-Šulović, MD
Pisa, Italy, 30.-31. August 2010
1
Institute of Public Health of Serbia
“Dr Milan Jovanovic Batut” http://www.batut.org.rs
Center for Analysis, Planing and
Organization of Health Care
MoH
Main activites
Health analysis and planning, health
monitoring and reporting, planning
of health services, analysis of
health risks in the community
and quality assurance of health care.
PHI +
PHI network
HIF
Providers
(All levels)
2
Purpose and Method
 To check implementation of some patients’ right five
years after legislation in Low of Health (2005) and to
research correlation with patients satisfaction.
 National patients' survey in December 2009. A
structured questionnaire was completed by patients,
after receiving the health care service in 87 hospitals
(five day population) and 163 primary health care
facilities (one day population).
 Overall patient satisfaction was measured using a five
point ordinal scale.
 Statistics’ method: frequency distribution, Chi-squared
test and multiple linear regression.
 Significance level (p) less than 0.05 was considered as
statistically significant.
3
Legislation and regulation
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Important aspects of patients’ rights have been addressed in the
Law on Health Care Protection (2005), including the following
topics:
Availability of health care according to health needs, resources and
equal access
Rights and obligations related to compulsory health insurance
Information to the patient + inform to duties
Free choice for patients (including choice of doctor)
Privacy and confidentiality of information and data
Self-determination and informed consent
Access to medical documentation
Dissatisfaction and complaints
Liability and compensation in case of health damage or harm
Public information on health protection (e.g. in work or in the event
of epidemics).
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Patient satisfaction survey with hospital care
(1)
 07.-12.12.2009.; 10.394
respondents; 87
hospitals
 Did you give written or
oral consent to the
procedures and
treatment?
 Yes 89.3%
 No 10,7%
 χ2 =112,976, df=3, p≤0.000
100
90
80
70
60
Yes
No
50
40
30
20
10
0
M
S
G&O
R
5
Patient satisfaction survey with hospital care
(2)
100
 Did staff informe
you about your
duties in hospital?
 Yes 87,8%
 No 12,2%
90
 χ2 =126,922, df=3, p≤0.000
20
80
70
60
Yes
No
50
40
30
10
0
M
S
G&O
R
6
Patient satisfaction survey with hospital care
(3)
 Do you aware of the
appeals and
complaints
mechanism?
 Yes 76,4%
 No 23,6%
 χ2 =298,939, df=3, p≤0.000
90
80
70
60
50
Yes
No
40
30
20
10
0
M
S
G&O
R
7
Patient satisfaction survey with hospital care
(4)
 How much are you satisfide with given
informatin about tests, procedures,
tretman and results? (five ordinal scale from very
dissetisfide to very setisfide)
 Dissetisfide
 Nurses 2,2%
 Doctors 2,2%
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Patient satisfaction survey with PHC servicies
general practis, pedijatrics & gynecologist (1)
 07.12.2009.; 57.527 respondents, 171 PHC facilities
 How did you choose your doctor?




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I chose my doctor 81,4%
Member of my family chose insted of me 6,6%
Did not choose, I get it 3,8%
I do not have chosen doctor 5,5%
Do not rememmber 2,7%
 χ2 =597,487, df=8, p≤0.000
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Patient satisfaction survey with PHC servicies
general practis, pedijatrics & gynecologist (2)
 Do you awere how
to make new
choise of doctor if
you wont?
 Yes, I can do it when
ever I wish 40,2%
 Yes, but I can do it ones
per year 32,1%
 I think it is not possible
3,7%
 Do not know 23,9%
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Patient satisfaction survey with PHC servicies
general practis, pedijatrics & gynecologist (3)
 My chosen doctor
give me clear
information of
diseases and
drugs.




Yes, I agree 84,8%
Partly agree 12,6%
Do not agree 2.6%
χ2 = 16.087, df = 4, p <
0.03
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Patient satisfaction survey with PHC servicies
general practis, pedijatrics & gynecologist (4)
 There is a box/book
for complaints and
appeals in PHC
servise
 Yes, I agree 73%
 Partly agree 5,7%
 Do not agree 3,7%
 Do not know 17,6%
 χ2 =209,775, df=6,
p≤0.000
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Conclusion (1)
 Multiple regression
test confirmed that all
the variables related
to patients’ rights are
statistically highly
significant on overall
satisfaction with
health care (p <0.000).
4,45
4,40
4,35
MW
4,30
SW
4,25
G&O
4,20
RW
4,15
Total
4,10
4,05
4,00
2005
2006
2007
2008
2009
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Conclusion (2)
 Almost 50% patients are not completely
aware about their rights after two
campaigns. We need beter strategy.
 There is a statistically significant
difference on patient awareness about the
rights to the various hospital departments
or PHC servicies.
 These results show that there is need for
special research of this issue. We should
check medical staff also.
 Patients’ rights is an efficient tool for
quality control, risk management, conflict
resolution and prevention of litigation.
Uh
…
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