Customer Quality: A Self-reporting Survey among Angiography Patients

Background and Objectives: The increasing pressure on health systems to improve quality of health care, require them to develop novel conceptual framework and indices aimed at evaluating decision variables in the contemporary complex community. Customer Quality is a newly introduced concept addressing capability of patients in contribution to healthcare process and cooperation with healthcare providers for an improved healthcare services provision. This concept has been suggested to be regarded as a new dimension to quality of healthcare delivery. To further explore the potential impact of this factor on clinical outcome and health care performance, this study surveys Customer Quality among angiography patients. Methods: In a cross-sectional study, 202 cardio-vascular patients from Educational-Medical Shahid-Madani Center (Tabriz, Iran) were surveyed in 2013. A 19-item 5-point Likert-type Customer Quality questionnaire was used for data collection. Based on cumulative score of response to the questions, the patients were categorized into four ordinal self-management-capability groups: 1-19: belief in the importance patient role in healthcare process improvement; 20-50: having adequate confidence and knowledge to participate in healthcare provision; 50-80: being ready to take action to improve health care outcome; >80: maintaining care practices even under stressful situations. The data were summarized using descriptive statistical methods. T-test and ANOVA were used to compare the mean values. Findings: The mean Customer Quality was calculated to be 60.42±10.07. While ~84.4% of the patients fell in the third self-management-capability category, ~86% stated that they can help prevention of diseases or decrease the risks related to their health, ~97.% believed that their participation in provision of healthcare services is important to their health improvement, ~83% stated that after receiving treatment from the medical teams, they themselves are responsible for their health, 75% of patients consider themselves as a member of health team, and ~53% stated that they are not informed about development and prognosis of their disease. Conclusions: Our results clearly indicate the positive attitudes of cardiovascular patients towards contributing to healthcare process and self-care. Despite strong implication of of this positive attitude in attaining a high Customer Quality level, its potential impact on healthcare performance remains untapped due to the limited knowledge of patients on the nature of their diseases and the associated health-care and health-efficacy. Our findings implies the need for systematic inclusion of training services in health setting for increasing the awareness of patients on different aspects of their diseases and improving their communicative and self-efficacy skills, in order to attain higher Customer Quality-based healthcare outcome.