Satisfaction of inpatients with acute coronary syndrome in Bulgaria

BACKGROUND Patient satisfaction constitutes an important indicator for the quality of care. During the last years, Bulgaria changed its socialist health care system to a market-driven system. Despite the fact that the improvement of health care quality and patient satisfaction were put on top of the list of goals for the health care reforms, no studies of patient satisfaction with inpatient care have been conducted so far.Since cardiovascular diseases are amongst the major causes of death in Bulgaria, and strenuous efforts have been made to improve the quality of medical care of patients with acute coronary syndrome (ACS) during the last years, patient satisfaction in this group can be seen as an important example of the Bulgarian reforms. This study therefore investigates patient satisfaction of inpatients with ACS. METHODS We performed structured face-to-face interviews with all patients with ACS, residing in a representative Bulgarian region who were discharged from hospitals in this region between September 1st and December 31st, 2004. We surveyed their socio-demographic status, overall satisfaction, change in complaints, self-perceived health status, functional possibilities in activities of daily living, satisfaction with life and self-reported condition at admission. We used descriptive methods as well as t-tests, chi-square tests, and logit models for data analysis. RESULTS Face-to-face interviews were carried out in 394 cases, of which 53.6% were men and 46.4% were women. 24% of the patients were satisfied with inhospital treatment, 62% were satisfied to some extent, and 14% were unsatisfied. The overall satisfaction of patients with ACS was significantly associated (p < 0.05) with the type of hospital, the number of family members living together and the severity of the disease at admission. Patients treated in urban and middle-size rural hospitals, patients living together with three or more family members, and patients with more severe conditions at admission reported higher satisfaction scores. CONCLUSION ACS patient satisfaction with inhospital treatment in Bulgaria shows much room for improvement. Information obtained from satisfaction studies could be used at decision-making and hospital-management levels for improving new strategies and structural changes in the Bulgarian health care system.