The satisfaction of citizens with medical care noticeably increased in 2022. Today this indicator is almost 42%, while a year earlier it was 1.5 times lower (25.8%). This is evidenced by the data of an all-Russian sociological study conducted by the Social Mechanics Center.
Its results were made public at the System of Compulsory Medical Insurance: Achievements, Problems and Prospects Round Table Discussion of the 13th All-Russian Congress of Patients.
The poll was conducted from October 1 to November 15, 2022 among the residents of 78 regions of Russia who received medical care under the Obligatory medical insurance policy (OMI) policy during the last 3 years. Satisfaction with the quality of free medical care today is at an average level, said the analysts.
“41.6% of respondents are satisfied with medical care under the OMI to some extent, and 22.9% are unsatisfied. In comparison with the data of 2021 the satisfaction has increased markedly. A year ago 25.8% were satisfied, and 37.4% are not satisfied,” said Tatiana Fomina, deputy director of the Social Mechanics Center of Social Technologies and Research. “We have seen a positive shift in the ratio. Indicators are quite significant: + 15% of citizens became more satisfied with medical care.”
Experts found that 48% of patients are generally satisfied with the attitude of medical professionals, and every fifth (19.4%) is not satisfied with it. Since last year, this figure has remained about the same.
Like a year ago, patients would appeal for protection of their rights first to the management of the servicing medical organization (34.4%) or to representatives of an insurance company (29.8%) and only then to the Ministry of Health, regional healthcare authorities, prosecutor's office and the Federal Service for Surveillance in Healthcare (Roszdravnadzor.) Moreover, almost one third of patients (29.5%) have already had experience in asking insurers for help, the analysts found out.
“In spite of relatively small increase of positive estimations of the state of the system the number of people who confidently say that the quality of medical care has increased, and it is a positive factor,” the vice-president of All-Russian Union of Insurers, Dmitry Kuznetsov said, commenting on the results of research those data. “They show attitude towards insurance medical organizations, show, that contribution of our colleagues is evident. Thanks to a fairly massive information support, the emphasis on dispensary care in our work. At the same time, of course, we can't influence all the problems of the health care system today.”
Patients still rate the quality and availability of medical services in hospitals much higher than that of outpatient care. Although the degree of satisfaction with this type of care among the OMI insured has significantly increased compared to the previous year (+19.3%).
In 2022, patients of out-patient clinics most often faced with long waiting time for an appointment at the doctor's office, according to the answers of 89% of respondents. Almost 87% of patients said that they faced with inability to get all necessary assistance in one medical institution. According to 85% of citizens, the main problem was the absence of the necessary specialist in the clinic or inability to make an appointment with him. On the other hand, the top 10 most common problems were added with new types of complaints related to service, such as: difficulty in getting through to the clinic to make an appointment for an examination, appointment or reference information (80%), as well as to call the doctor at home (57%).
Only 2% of respondents have not encountered any problems at all in receiving outpatient and polyclinic medical care under the OMI. In 2021, this indicator was slightly higher (2.5%.)
Meanwhile, satisfaction with inpatient medical care in 2022 increased compared to a year earlier: by 9.8% in hospitals of regional or municipal subordination, and by 5.2% in hospitals of federal subordination.
Most often patients face additional expenses in hospitals: for purchasing medicines prescribed by a doctor at their own expense (45%), for taking paid tests and/or undergoing additional examinations before hospitalization (36.8%), with additional expenses for paid services during hospitalization (34.7%), for purchasing consumable materials at their own expense (32.3%).
More than a third of citizens who were treated in hospital encountered inappropriate behavior of medical workers – this was reported by almost 38% of respondents.
As part of the study, analysts found out the attitude of patients to paid medicine.
“Always when there are some shortcomings, fee-for-service medicine performs a compensatory function. And this information always gives us an idea of what exactly the citizens are dissatisfied with in the OMI system and why they go to fee-for-service medicine,” said Tatiana Fomina.
It turned out that only 4.5% of citizens do not intend to use paid medical services and will use only medical care under the compulsory health insurance policy. Every fourth patient (26.4%) will use paid medical services, when the necessary examinations or procedures under the policy of compulsory medical insurance will not be available and they can be received only in private clinics. Approximately the same number (24.9% of citizens) will resort to paid medicine when they need urgent medical care.
A measurement of patients’ attitudes toward the upcoming digitalization showed that the majority view this novelty positively, although they have some fears about digitizing medical records. For example, 80.3% of patients believe that digitalization of care has advantages over the previous system. But only a quarter (26.5%) of patients have no particular fears about the digitalization of health care. Patients are most concerned about the risk of missing, disappearing data when stored electronically (37.7%) and unauthorized access to data (35.2%).