STUDY OF THE RISK OF PARENTS’ DISSATISFACTION WITH THE QUALITY OF PROVIDING MEDICAL AID TO CHILDREN WITH RESPIRATORY DISEASES

Abstract

Introduction. Reforming the health care system requires defining criteria for assessing patients’ dissatisfaction with the quality of medical care. It is known that the previous experience of communication with a doctor affects the quality of further interaction and compliance with medical recommendations. The aim was to predict the risk of parents’ dissatisfaction with the quality of medical care for children with respiratory diseases, depending on the number and reasons for visits to pediatricians and family general practitioners (GP), by the results of the questionnaire. Materials and methods. Overall, 171 parents were questioned (87.72 %). The analysis was by logistic regression models using the statistical analysis package MedCalc v.19.4.1 (MedCalc Software Inc, Broekstraat, Belgium, 1993-2020). Results. The results of the study show that 125 (83.3 %) parents rated satisfaction with the quality of medical care for children with respiratory diseases (RD) in health care facilities as 5 points by a five-point scale. The univariate analysis showed a significant relationship between the risk of parents’ dissatisfaction with the quality of medical care for RD children and the number of ARI visits to the GPs per year (p<0.05), namely: the increase in the number of visits is associated with significant decrease in parental dissatisfaction with quality of medical care, for every next visit (p = 0.040), OR = 0.31 (95 % CI 0.10-0.95). The area under the curve of operational characteristics AUC = 0.66 (95 % CI 0.58-0.74) indicates a weak relationship between the risk of parental dissatisfaction and the number of ARI visits to the GPs per year. When using the stepwise regression, 4 factor features were selected for multivariate analysis, namely: the number of cases of acute respiratory viral infections in a child per year, the number of pneumonias in a child during life, the number of visits to the PHC (primary health care) physician, and to the PHC pediatrician per year. According to this model, an increase in the number of visits to the GP is associated with decrease in parents’ dissatisfaction with the quality of medical care, for each repeated visit (when standardizing by the number of ARI cases in a child per year, the number of pneumonia cases in a child, and the number of visits to the PHC pediatrician) (p = 0.026), OR = 0.25 (95 % CI 0.08-0.85). Conclusions. The multifactorial factor logistic regression of the parental dissatisfaction with the quality of medical care for ARI children included 4 factors, including the number of cases of acute respiratory viral infections in a child per year, the number of pneumonias in a child during life, the number of visits to the GP, and to the PCH pediatrician per year. For every next RD-associated visit to the physician, the risk of dissatisfaction with the medical care quality significantly reduces. Positive previous experience of communication between parents and the GP leads to further satisfaction with the quality of medical care for RD children.