Methods

Sample size determination

In calculating sample size various considerations such as prior estimate of indicator variables,

desired precision effect etc. were taken into consideration. In this study there are a number of

indicator variables with different levels of assumed proportions (P). Therefore samples of

different sizes were found for different values of P. From practical consideration, it was decided

to take a single sample which would ensure desired precision in satisfying the objective.

Sample size was estimated by

Z2pq

n = ————————

d2

where

n = estimated sample size

p = prevalence of patient satisfied about medical health care = 50.0% = 0.50

q = 1 – p = 1 – 0.50 = 0.50

Z = 1.96 value of Z corresponding to 95% confidence interval

d = margin of error (% relative error) = 0.05. The estimated sample size was:

1.962 0.50 0.50

n = ———————————— = 384

0.052

the estimated sample size was 384..

VARIABLES OF THE STUDY

Age, sex, education, occupation, monthly income, nativity, Perception of patients toward

admission procedure, physical facilities, diagnostic service, behaviour of staff, cleanliness, mode

of admission, sign board, laboratory service etc were the study variable.

QUESTIONNAIRE DESIGN

Two sets of questionnaire were used for the study. One for socio-demographic characteristic and another for health care medical related.

Data collection

Study participants were drawn from a large cross-sectional health study conducted in ….. ……………………..

Statistical analysis:

Before finalization of the data for computer entry, each questionnaire was cross-checked for final

editing. After completion of necessary coding and editing the analysis was undertaking using

SPSS software package, EPI Info and Harvard graphics. Chi-square test was done to find out the

association.

Table 1: Socio-demographic characteristics of the study subjects

Variables Number Percentage Age in years (n=384):Age < 30 years

31-50

> 50 years

215

106

63

56.0

27.6

16.4

Sex (n=384):Male

Female125

259

32.6

67.4

Educational status of the subjects (n=384):

Illiterate

< SSC

SSC to Degree

above degree

146

178

57

3

38.0

46.4

14.8

.8

Occupation (n=384):

Government service

Private

Business

Agriculture

Others

19

64

42

66

193

4.9

16.7

10.9

17.2

50.3

Income (in Taka) (n=384):

< 5000

5000-10000

10000-20000

> 20000

92

115

44

133

24.0

29.9

11.5

34.6

Resident (n=384):

Rural

Urban

360

24

93.8

6.3

Table 1 showed the socio-demographic characteristic of the study subjects. It was found that

majority 56.0 percent of the subject had age below 30 years. The rest 27.6 percent and 16.4 were

in age group in 31-50 years and above 50 years respectively. More than 67 percent of the

subjects were female and 32.6 percent were. Among them 38.0 percent were illiterate and 62.0

percent were literate. Service holder, private, businessmen and farmer were 4.9, 16.7, 10.9 and

17.2 percent respectively. The rest 50.3 percent had others occupation. It was found that 24.0

percent of the subject had monthly household income < 5000 taka. The rest 76.0 percent had

monthly income ≥ 5000 taka. Majority 93.8 percent of the subjects came from rural and 6.3

percent came from rural.

Table 2: Perception of patients toward admission procedure

Patient satisfactory questioner (PSQ 7.1-7.5)

Number% of total

Strong agree

Agree Can’t say

Disagree Strongly disagree

Total

Admission procedure of

the hospital is good

(PSQ-7.1)

Number 109 269 3 3 0 384

% of

total 28.4 70.1 0.8 0.8

0100.0

People at registration

counter are helpful (PSQ-

7.2)

Number 83 267 12 20 2 384

% of

total 21.6 69.5 3.1 5.2 0.5 100.0

Do you mind delay for

admission (PSQ-7.3)

Number 70 142 23 131 18 384

% of

total 18.2 37.0 6.0 34.1 4.7 100.0

Reception service is good

(PSQ-7.4)

Number 77 278 12 13 4 384

% of

total 20.1 72.4 3.1 3.4 1.0 100.0

On the whole registration

procedure is good (PSQ-

7.5)

Number 84 283 12 4 1 384

% of

total 21.9 73.7 3.1 1.0 0.3 100.0

Multiple responses (%) of patient toward admission procedure (PSQ-7.1 through PSQ7.5)

Count 423 1239 62 171 25 1920% of

total 22.0 64.5 3.2 8.9 1.3 100.0

Perception of patients toward admission procedure such as good procedure of admission, helpful

people at registration counter, delay for admission, good service at reception and overall good

procedure of registration were presented by Table 2 and Figure 1. Multiple responses of patient

(PSQ-7.1 through PSQ7.5) showed that 22.0 percent, 64.5 percent, 3.2 percent, 8.9 percent and

1.3 percent were presented by strong agree, agree, can’t say, disagree and strongly disagree

respectively.

Figure 1: Multiple responses (%) of patient toward admission procedure (PSQ-7.1 through PSQ7.5)

Strong agree Agree Can’t say Disagree Strongly disagree

0

10

20

30

40

50

60

11.6

58.5

19.9

8.9

1

Per

cent

Table 3: Perception of patients towards physical facilities

Patient satisfactory questioner (PSQ 8.1-8.5)

Number% of total

Strong agree

Agree Can’t say

Disagree Strongly disagree

Total

Wheel chair & trolley service are satisfactory (PSQ-8.1)

Number 67 245 46 19 7 384% of total

17.4 63.8 12.0 4.9 1.8 100.0

Do you find difficulty getting bed (PSQ-8.2)

Number 63 200 14 95 12 384% of total

16.4 52.1 3.6 24.7 3.1 100.0

Cleanliness in the word/room is good (PSQ-8.3)

Number 85 277 8 12 2 384% of total

22.1 72.1 2.1 3.1 0.5 100.0

Do you think this hospital is comfortable (PSQ-8.4)

Number 61 302 12 7 2 384% of total

15.9 78.6 3.1 1.8 0.5 100.0

Toilet facilities are good (PSQ-8.5)

Number 48 243 20 70 3 384% of total

12.5 63.3 5.2 18.2 0.8 100.0

Multiple responses (%) of patient toward physical facilities (PSQ-8.1 through PSQ-8.5)

Count239 990 92 191 24 1536

% of total

15.6 64.5 6.0 12.4 1.6 100.0

Perception of patients towards physical facilities such as good service of wheel chair & trolley,

difficulty of getting bed, Cleanliness in the word/room, hospital is comfortable and good

facilities of toilet were presented by Table 3 and Figure 2. Multiple responses of patient toward

physical facilities (PSQ-8.1 through PSQ-8.5) showed that 15.6 percent, 64.5 percent, 6.0

percent, 12.4 percent and 1.6 percent were presented by strong agree, agree, can’t say, disagree

and strongly disagree respectively.

Figure 2: Multiple responses (%) of patient toward physical facilities (PSQ-8.1 through PSQ-8.5)

Strong agree

Agree Can’t say Disagree Strongly disagree

0

10

20

30

40

50

60

11.6

58.5

19.9

8.9

1

Per

cent

Table 4: Perception of patients towards diagnostic service

Patient satisfactory questioner (PSQ 9.1-9.5)

Number% of total

Strong agree

Agree Can’t say

Disagree Strongly disagree

Total

Diagnostic service are good (PSQ-9.1)

Number 69 244 58 10 3 384

% of total 18.0 63.5 15.1 2.6 0.8 100.0

Doctors give much attention to the patient (PSQ-9.2)

Number 102 255 22 4 1 384

% of total 26.6 66.4 5.7 1.0 0.3 100.0

Do doctors give proper medical care (PSQ-9.3)

Number 104 247 28 3 2 384

% of total 27.1 64.3 7.3 0.8 0.5 100.0

Sophisticated equipment are used for investigation in comfortable (PSQ-9.4)

Number 59 180 126 16 3 384

% of total 15.4 46.9 32.8 4.2 0.8 100.0

On the whole hospital is providing satisfactory service (PSQ-9.5)

Number 73 283 24 3 1 384

% of total 19.0 73.7 6.2 0.8 0.3 100.0

Multiple responses (%) of patient toward diagnostic service (PSQ-9.1 through PSQ-9.5)

Count407 1209 258 36 10 1920

% of total 21.2 63.0 13.4 1.9 0.5 100.0

Perception of patients towards diagnostic service such as good service of diagnostic, attention of

doctors the patient, proper medical care of doctors, sophisticated equipment are used for

investigation and overall satisfactory of service of hospital were presented by Table 4 and Figure

3. Multiple responses of patient toward diagnostic service (PSQ-9.1 through PSQ-9.5 showed

that 21.2 percent, 63.0 percent, 13.4 percent, 1.9 percent and 0.5 percent were presented by

strong agree, agree, can’t say, disagree and strongly disagree respectively.

Figure 3: Multiple responses (%) of patient toward diagnostic service (PSQ-9.1 through PSQ-9.5)

Strong agree

Agree Can’t say Disagree Strongly disagree

0

10

20

30

40

50

60

11.6

58.5

19.9

8.9

1

Per

cent

Table 5: Perception of patients towards behavior of staff

Patient satisfactory questioner (PSQ 10.1-10.6)

Number% of total

Strong agree

Agree Can’t say

Disagree Strongly disagree

Total

Doctors how given enough time to narrate the illness (PSQ 10.1)

Number 139 228 15 0 2 384% of total

36.2 59.4 3.9 0 0.5 100.0

Attitude of doctors is satisfactory (PSQ 10.2)

Number 142 223 17 0 2 384% of total 37.0 58.1 4.4 0 0.5 100.0

No. of round made by doctors is reasonable (PSQ 10.3)

Number 125 237 20 1 1 384% of total

32.6 61.7 5.2 0.3 0.3 100.0

Behavior of ayas, word boy, sweepers are satisfactory (PSQ 10.4)

Number 73 221 33 56 1 384% of total

19.0 57.6 8.6 14.6 0.3 100.0

Behavior of nurse staff is satisfactory (PSQ 10.5)

Number 90 254 26 12 2 384% of total 23.4 66.1 6.8 3.1 0.5 100.0

Staff service & level of care is good (PSQ 10.6)

Count 78 264 26 12 4 384% of total 20.3 68.8 6.8 3.1 1.0 100.0

Multiple responses (%) of patient toward behavior of staff (PSQ-10.1 through PSQ-10.6)

Count647 1427 137 81 12 2304

% of total 28.1 61.9 5.9 3.5 0.5 100.0

Perception of patients towards behavior of staff such as doctors given enough time to narrate the

illness, satisfactory attitude of doctors, number of reasonable round made by doctors,

satisfactory behavior of ayas, word boy, sweepers, satisfactory behavior of nurse and good staff

service & level of care were presented by Table 5 and Figure 4. Multiple responses of patient

toward behavior of staff (PSQ-10.1 through PSQ-10.6) showed that 28.1 percent, 61.9 percent,

5.9 percent, 3.5 percent and 0.5 percent were presented by strong agree, agree, can’t say,

disagree and strongly disagree respectively.

Figure 4: Multiple responses (%) of patient toward behavior of staff (PSQ-10.1 through PSQ-10.6)

Strong agree Agree Can’t say Disagree Strongly disagree

0

10

20

30

40

50

60

11.6

58.5

19.9

8.9

1

Per

cent

Table 6: Perception of patients towards cleanliness

Patient satisfactory questioner (PSQ 11.1-11.5)

Number% of total

Strong agree

Agree Can’t say

Disagree Strongly disagree

Total

Linen is clean in the hospital (PSQ-11.1)

Number 94 265 13 12 0 384

% of total 24.5 69.0 3.4 3.1 0 100.0

Cleanliness in the room/word is good (PSQ-11.2)

Number 83 280 13 8 0 384

% of total 21.6 72.9 3.4 2.1 0 100.0

Toilets are properly cleaned (PSQ-11.3)

Number 58 217 34 74 1 384% of total 15.1 56.5 8.9 19.3 0.3 100.0

Sweepers are adequate number in hospital (PSQ-11.4)

Number 64 209 57 52 2 384% of total 16.7 54.4 14.8 13.5 0.5 100.0

Sweepers properly clean the hospital (PSQ-11.5)

Number 54 230 46 50 4 384% of total 14.1 59.9 12.0 13.0 1.0 100.0

Multiple responses (%) of patient toward cleanliness (PSQ-11.1 through PSQ- 11.5)

Count353 1201 163 196 7 1920

% of total

18.4 62.6 8.5 10.2 0.4 100.0

Perception of patients towards cleanliness such as cleanliness of linen in the hospital, cleanliness

in the room/word, cleanliness of toilets, adequate number of sweepers are in hospital and

properly clean the hospital were presented by Table 6 and Figure 5. Multiple responses of patient

toward cleanliness (PSQ-11.1 through PSQ- 11.5) showed that 18.4 percent, 62.6 percent, 8.5

percent, 10.2 percent and 0.4 percent were presented by strong agree, agree, can’t say, disagree

and strongly disagree respectively.

Figure 5: Multiple responses (%) of patient toward cleanliness (PSQ-11.1 through PSQ- 11.5)

Strong agree Agree Can’t say Disagree Strongly disagree

0

10

20

30

40

50

60

11.6

58.5

19.9

8.9

1

Per

cent

Table 7: Perception of patients towards cleanliness about foods and others

Patient satisfactory questioner (PSQ 12.1-12.7)

Number% of total

Strong agree

Agree Can’t say

Disagree Strongly disagree

Total

Served food is testy and hygienic (PSQ-12.1)

Number 61 274 23 19 7 384% of total 15.9 71.4 6.0 4.9 1.8 100.0

Served food is hot and in time (PSQ-12.2)

Number 67 284 19 11 3 384% of total 17.4 74.0 4.9 2.9 0.8 100.0

Food served as per suggestion of doctor (PSQ-12.3)

Number 51 252 60 20 1 384% of total 13.3 65.6 15.6 5.2 0.3 100.0

Are you satisfied with the canteen menu (PSQ-12.4)

Number 39 197 106 37 5 384% of total 10.2 51.3 27.6 9.6 1.3 100.0

Canteen price are reasonable (PSQ-12.5)

Number 31 179 125 45 4 384% of total 8.1 46.6 32.6 11.7 1.0 100.0

Plate and glass are properly washed (PSQ-12.6)

Count 29 228 83 40 4 384% of total 7.6 59.4 21.6 10.4 1.0 100.0

Are you satisfied with the seating arrange in canteen

Number wq 159 120 66 4 383% of total 8.9 41.5 31.3 17.2 1.0 100.0

Multiple responses (%) of patient toward cleanliness of foods (PSQ-12.1 through PSQ- 12.7)

Number 312 1573 536 238 28 2687% of total

11.6 58.5 19.9 8.9 1.0 100.0

Perception of patients towards cleanliness about foods and others such as testy and hygienic

Served food, hot and timely served food, served food as per suggestion of doctor, satisfaction

with the canteen menu, reasonable price of canteen foods, plate and glass are properly washed

and satisfied with the seating arrange in canteen were presented by Table 7 and Figure 6.

Multiple responses of patient toward cleanliness of foods (PSQ-12.1 through PSQ- 12.7)

showed that 11.6 percent, 58.5 percent, 19.9 percent, 8.9 percent and 1.0 percent were presented

by strong agree, agree, can’t say, disagree and strongly disagree respectively.

Figure 6: Multiple responses (%) of patient toward cleanliness of foods (PSQ-12.1 through PSQ- 12.7)

Strong agree Agree Can’t say Disagree Strongly disagree

0

10

20

30

40

50

60

11.6

58.5

19.9

8.9

1

Per

cent

Table 8: Perception of patients towards mode of admission

Variables Number Percentage

Word attendant / support staff for admission at emergency : yesNoNo respond

19117815

49.746.43.9

Word location:ApproachableDifficult to approach

34044

88.511.5

Sign Board:Adequate and helpfulInadequate

35034

91.18.9

Time taken between admission and initiation of treatment:Time given by doctors of the time of admissionImmediate< 10 min. 10 min.-30 min.

322539

83.913.82.3

General communication of dictor:GoodSatisfactoryUnsatisfactory

3134229

81.510.97.6

General communication of doctors:Good SatisfactoryUnsatisfactory

339405

88.310.41.3

Perception of efficiency of doctors in handling illness of patients:SatisfactoryUnsatisfactory

35727

93.07.0

Doctors discussed about investigations with patient:SatisfactoryUnsatisfactory

36519

95.14.9

No. of visits of doctors / consultant:SatisfactoryUnsatisfactory

36420

94.85.2

Waiting area is comfortable:SatisfactoryUnsatisfactory

34242

89.110.9

Table 9: Perception of quality of laboratory service

Variables Number Percentage Availability of lab. technicians:YesNo

33945

88.311.7

Approach / behaviour of lab. technician:YesNo

34143

88.811.2

Availability of investigation report:Available on schedule timeDelayed

33450

87.013.0

Table 10: Perception regarding quality of service by nursing and paramedical staff

Variables Number Percentage No. / availability of nursing staff in ward:AdequateInadequate

32551

84.613.3

Communication / behavior of nurse and para medical staff:GoodPleasantSatisfactory harsh / ruchAvoiding

324283011

84.47.37.80.30.3

Dispensary provides prescribed medicine timely:YesNoHas to be asked

3322725

86.57.06.5

Approach of paramedical staff to1ward patient:SatisfactoryNot satisfactory

35925

93.56.5

Service and support of paramedical staff:SatisfactoryNot satisfactory

36420

94.85.2

Tble 11: Association of sex with perception toward good procedure of admission, satisfaction about physical facilities, good diagnostic service, good behavior

of staff, cleanliness overall satisfaction about hospital service.

Sex Perception Agree

(percent of multiple responses)

Disagree(percent of multiple

responsesMale 76 24

Female 80 20

Chi-square = 0.26 P = 0.608 not significant at 5 percent level.

Based on Chi-square test (Chi-square = 0.26, P = 0.608) it was found that sex was not

significantly associated with the perception toward good procedure of admission, satisfaction

about physical facilities, good diagnostic service, good behavior of staff, cleanliness overall

satisfaction about hospital service.

Tble 12: Association of educational level with perception toward good procedure of

admission, satisfaction about physical facilities, good diagnostic service, good behavior of staff, cleanliness overall satisfaction about hospital service

Education Perception Agree

(percent of multiple responses)

Disagree(percent of multiple

responsesIlliterate 80 20

Literate 86 14

Chi-square = 0.89 P = 0.346 not significant at 5 percent level.

Based on Chi-square test (Chi-square = 0.89, P = 0.346) it was found that educational level was

not significantly associated with the perception toward good procedure of admission, satisfaction

about physical facilities, good diagnostic service, good behavior of staff, cleanliness overall

satisfaction about hospital service.