Users’ satisfaction with the Romanian health care system: an evaluation of recent health care reforms

Background: Satisfaction surveys are valuable instruments to evaluate the quality of a health care system and of changes in the system and to provide feedback for health care professionals and policymakers. Objective: This study aims to explain the level of satisfaction by looking for predictors of satisfaction. The potential predictors include demographic variables, users health status, users opinions about the changes in the health care system and under-the-table payments. Method: A survey on the new health care system in Romania was carried out using face-to-face interviews with 619 Romanian citizens from the Dolj region. The satisfaction questions included the evaluation of the health care system in general and the evaluation of relevant institutions and providers. Results: There were three basic findings. Firstly, the level of users satisfaction with the new health care system is rather high, but not for hospital care in Romania. Secondly, satisfaction with the new health care system in general is relatively strongly related to satisfaction with health care providers, i.e. general practitioners, medical specialists, dentists and pharmacists. Thirdly, men, more educated people, people who offered "gifts" and those who judged the new system as more inaccessible, of less quality or showing no improvement in physicians behavior were less satisfied than their counterparts. Conclusion and implications: The transition of the health care system in Romania is evaluated positively by the majority of the population but, at the same time, there is a necessity for programs to address inaccessibility, quality of care and under-the-table payments.