|Year : 2015 | Volume
| Issue : 3 | Page : 324-327
Patient satisfaction in outreach dental programs of a Dental Teaching Hospital in Modinagar (India)
Vaibhav Vashishtha, Basavaraj Patthi, Ashish Singla, Ritu Gupta, Ravneet Malhi, Venisha Pandita
Department of Public Health Dentistry, D.J College of Dental Sciences and Research, Ghaziabad, Uttar Pradesh, India
|Date of Web Publication||14-Sep-2015|
Department of Public Health Dentistry, D.J College of Dental Sciences and Research, Ajit Mahal, Niwari Road, Modinagar, Ghaziabad - 201 204, Uttar Pradesh
Source of Support: None, Conflict of Interest: None
Introduction: Patient satisfaction with dental services has received minimal attention in India. The perceptions of satisfaction of the oral health care service among patients in outreach dental programs and their level of satisfaction are an important factor toward improving the service provided. Aim: To assess patient satisfaction at outreach dental programs of a Dental Teaching Hospital in Modinagar India. Materials and Methods: A cross-sectional study was conducted among patients attending community dental outreach programs organized by the Dental Teaching Hospital over a period of 1-month. A total of 4 weekly and 1 monthly camp were included, and all the subjects who attended these camps were administered the pretested structured questionnaire. The questions were related to the satisfaction level of the patient in outreach dental camps and answers were recorded using a four-point "Likert" scale with Chi-square and independent t-test were used for statistical analysis. Results: The results showed that level of satisfaction among patients were higher in weekly camps (95.2%) as compared to monthly camps that is (80%). The response rate for the weekly camps was 95.2%, whereas for the monthly camp was 80%. Overall patient satisfaction scores with the care received ranged from the poor (1) to excellent (4). The highest reported levels of satisfaction were for the aspects of explanation of dental treatment by the doctor followed by meeting of perceived need of the patient with the treatment. Conclusion: Patient satisfaction with the community dental outreach programs was high, reflecting the delivery of quality treatment and positive attitude of the dental team during the camps. The overall high level of patient satisfaction reflected the dental team's approach of responsibility and accountability toward the target population.
Keywords: Dental camps, dental care, India, outreach program, patient satisfaction
|How to cite this article:|
Vashishtha V, Patthi B, Singla A, Gupta R, Malhi R, Pandita V. Patient satisfaction in outreach dental programs of a Dental Teaching Hospital in Modinagar (India). J Indian Assoc Public Health Dent 2015;13:324-7
|How to cite this URL:|
Vashishtha V, Patthi B, Singla A, Gupta R, Malhi R, Pandita V. Patient satisfaction in outreach dental programs of a Dental Teaching Hospital in Modinagar (India). J Indian Assoc Public Health Dent [serial online] 2015 [cited 2020 Jul 10];13:324-7. Available from: http://www.jiaphd.org/text.asp?2015/13/3/324/165284
| Introduction|| |
During the last decade, increasing attention has been paid to the quality of health care as a means to enhance the effectiveness of health care systems in developing countries. There is also increasing recognition of patient satisfaction as an important indicator of the quality of health care. Satisfaction of patient has long been considered an important component of care outcomes and is frequently integrated into evaluations of the overall quality of health services. 
Patient satisfaction is the degree of congruence between a patient's expectation of ideal care and their perceptions of actual care received. It is worthwhile noting that patient satisfaction is a multidimensional concept. , Some of the recognized dimensions of health care satisfaction include: The technical aspects of care related to the process of diagnosis and treatment; interpersonal aspects such as staff attitude; accessibility/availability; affordability; efficacy/outcomes; continuity of care; and facilities.  Patient satisfaction with dental care has an added importance regarding an association between satisfaction with care and patient behavior, in terms of compliance and utilization of services. 
In India, the accessibility and utilization of dental health services are still governed by inverse care law. Those in the utmost need of care have limited access to the health services.  The oral health services in the India are still limited to the urban areas and provided mostly by the private practitioners. The rural areas which house 75% of the Indian population have still have only one dentist caring for 2.5 lakh people; while it is one dentist for 10,000 people in the urban area.  The organized oral health care delivery system has failed to bridge this accessibility gap between urban and rural areas.
The community outreach programs are an essential part of public health services, helping health professionals reach the weaker sections of the society for delivery of basic oral health services. The services provided through these programs include patient education, thorough dental examination and consultation, oral prophylaxis, temporary restorations, extractions, and referral. However, the quality of the services provided through these camps and hence the patient satisfactions in these programs are always at the helm of scrutiny because of the limited availability of resources, workforce, and time.
A very few documented literature has been available on the patient satisfaction in the community dental outreach programs. Shrestha et al.  reported mean patient satisfaction from satisfactory to excellent. However, Ankola et al.  found that only 51% of the respondents were fully satisfied with the services provided at outreach programs. About 51% of the respondents were fully satisfied as others felt that the treatment was insufficient.
Modinagar is a city and a Municipal Board in Ghaziabad district in the Indian state of Uttar Pradesh. Average literacy rate of Modinagar city is 90%. The dental care utilization among the rural population of Modinagar is primarily dependent on the available one Dental College and Hospital in the city.  Therefore, this study was conducted to assess the level of satisfaction in the patients attending the monthly and weekly community outreach dental camps conducted by the Dental Teaching Hospital over the period of 2 months in the rural areas of Modinagar.
| Materials and methods|| |
A cross-sectional study was conducted among patients attending community dental outreach programs organized by the Dental Teaching Hospital over a period of 1-month. The protocol of the study was reviewed and approved by the Institutional Ethical Committee. The written informed consent was obtained from the study subjects after explaining them the purpose and methodology of the study.
The structured questionnaire on the patient satisfaction was developed focusing the probable preferences concerning the dental treatment of local population after discussing with the experts and translated to the local language (Hindi). A 14-item questionnaire was self-administered by the interviewer and was checked for reliability and validity through test - retest method. The reliability of the questionnaire was found to be good (Cronbach's alpha = 0.85). The responses to the questions on the patient satisfaction was recorded on a 4 point Likert scale ranging from excellent (4) to poor (1).
The monthly and weekly camps were organized in the Niwari and Sikri Village respectively which fall in 7 km and 2 km distance from Dental Teaching Hospital. The total of 4 weekly and 1 monthly camp was included for the purpose of the study. All the subjects who attended these camps (who attended and those who got treatment) were administered the pretested structured questionnaire. A total of 300 respondents from the four weekly and 100 respondents from the 1 monthly camp responded to the questionnaire for the study (including those who attended and who got the treatment).
The data were entered in the Microsoft Excel spreadsheet and processed using the Statistical Package for Social Sciences (SPSS) version 19 (SPSS Inc., Chicago, IL, USA). A frequency distribution of responses was performed. Chi-square test was used to compare the responses from weekly camps with those of monthly camps. The independent sample t-test was used to compare mean satisfaction scores of weekly camps with monthly camps.
| Results|| |
The response rate for the weekly camps was 95.2%, whereas for the monthly camp was 80%. A total of 400 participants (100 from monthly and 300 from weekly) responded to the questionnaire. The results of the study showed that overall patient satisfaction scores with the care received ranged from the poor (1) to excellent (4).
The responses for the majority of the questions on patient satisfaction during the community outreach camps ranged in the category of excellent and good. Of total, 99.5% of the respondents were satisfied with the overall performance of the camp. According to the question of quality of treatment given during the camp 96.0% were satisfied. The location/distance of the campsite was the one aspect with which 36.0% of the respondents were not satisfied [Table 1]. When the comparison was made for the weekly and monthly camps, the overall mean patient satisfaction was higher for the weekly camps (3.89 ± 0.63) as compared to the monthly camps (3.67 ± 0.69), and the difference was statistically significant [Table 2]. For all the question except for the cleanliness during the camps and performance with respect to other camps, the mean patient satisfaction score was significantly higher for the weekly camps as compared to monthly camps (P ≤ 0.05) [Table 3].
|Table 1: Overall patient satisfaction in both weekly and monthly dental camps |
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| Discussion|| |
Studies have shown that expectations of patients are based on their experiences, the environment, social background, and personality.  The key aspects of the patient satisfaction identified in the present study included quality of treatment provided, meeting of the perceived needs of the patients, attitude of the dentist, and auxiliary staff toward the patient and initial dental checkup during the camp. The findings are in agreement with the study of Sur et al.  and Bockting et al.  who have reported five key factors for patient satisfaction-technical competence, interpersonal relationship, quality, perceived need, and cost. For a rural population; the factors like patient's behavior, limited awareness and treatment cost are the main influencing factors affecting patient's satisfaction. 
The level of the patient satisfaction was higher in the weekly camps as compared with the monthly camps the findings are consistent with the findings of Butters and Willis.  Weekly camps saw fewer patients, enabling the provision of treatment in a less hurried fashion than at monthly camps. Moreover, at weekly camps more treatment modalities could also be provided per patient, and recall and review could be performed more frequently than at monthly camps. These factors could account for higher patient satisfaction with the weekly camps. ,,
The results of the present survey showed that the patients were satisfied with the services provided in the community dental outreach programs. However, the results of this study must be interpreted with judiciously. First, the survey instrument was based on commonly identified aspects of patient satisfaction, and because the study involved the rural population, a Hindi (local language) version was used. Therefore, comparison with other studies using standard instruments like the dental satisfaction questionnaire  or dental visit satisfaction scale  is not possible. Further the limited sample size of 400 could affect the generalization of the study results to the wider population base.
| Recommendation|| |
Patient satisfaction evaluation should be done as an adjunct in outreach programs, so as to facilitate the better provision of services to the people. In order to improve the patient satisfaction and dental attendance, further investigations should be carried out to indentify the barriers and control them by appropriate intervention and education.
| Conclusions|| |
Patient satisfaction with the community dental outreach programs was high, reflecting the delivery of quality treatment and positive attitude of the dental team during the camps. The patient satisfaction was more in the weekly camps as compared to the monthly camps. The location/distance of the campsite was identified as the one factor, with which the target population was not satisfied.
Financial support and sponsorship
Conflicts of interest
There are no conflicts of interest.
| References|| |
Zini A, Pietrokovsky J, Dgani A, Dgani R, Handelsman M. Survey of patient satisfaction at the Yad Sarah Geriatric Dental Clinic. Refuat Hapeh Vehashinayim 2006;23:36-41, 70.
Baltussen RM, Yé Y, Haddad S, Sauerborn RS. Perceived quality of care of primary health care services in Burkina Faso. Health Policy Plan 2002;17:42-8.
Mahfouz AA, Al-Sharif AI, El-Gama MN, Kisha AH. Primary health care services utilization and satisfaction among the elderly in Asir region, Saudi Arabia. East Mediterr Health J 2004;10:365-71.
Shrestha A, Doshi D, Rao A, Sequeira P. Patient satisfaction at rural outreach dental camps-a one year report. Rural Remote Health 2008;8:891.
Butters JM, Willis DO. A comparison of patient satisfaction among current and former dental school patients. J Dent Educ 2000;64:409-15.
Shah N. Geriatric oral health issues in India. Int Dent J 2001;51 3 Suppl: 212-8.
Gambhir RS, Brar P, Singh G, Sofat A, Kakar H. Utilization of dental care: An Indian outlook. J Nat Sci Biol Med 2013;4:292-7.
Ankola AV, Arpit G, Hebbal MI. Evaluating a comprehensive oral healthcare programme at village Ganikop in Karnataka-India. J Oral Sign 2012;4:67-72.
Available from: http://www.census2011.co.in/census/city/103-modinagar.html. [Last accessed on 2015 Feb 16; Last updated on 2015 Jan 10].
Skaret E, Berg E, Raadal M, Kvale G. Factors related to satisfaction with dental care among 23-year olds in Norway. Community Dent Oral Epidemiol 2005;33:150-7.
Sur H, Hayran O, Yildirim C, Mumcu G. Patient satisfaction in dental outpatient clinics in Turkey. Croat Med J 2004;45:651-4.
Bockting W, Robinson B, Benner A, Scheltema K. Patient satisfaction with transgender health services. J Sex Marital Ther 2004;30:277-94.
Bhushan P, Kumar MK, Prasant MC. Study of reason for low OPD at SMBT dental college: An open ended questionnaire survey. Am J Adv Med Sci 2014;2:26-33.
Al-Mudaf BA, Moussa MA, Al-Terky MA, Al-Dakhil GD, El-Farargy AE, Al-Ouzairi SS. Patient satisfaction with three dental speciality services: A centre-based study. Med Princ Pract 2003;12:39-43.
Chu CH, Yeung CY, Lo EC. Monitoring patient satisfaction with university dental services under two fee-paying systems. Community Dent Oral Epidemiol 2001;29:390-8.
Kashinath K, Bharateesh J, Agali C, Mythri H, Bennadi D, Kumar M. Factors affecting patient satisfaction among those attending an outpatient department of a dental college in Tumkur city. J Dent Res 2010;1:1-10.
[Table 1], [Table 2], [Table 3]