'Some patients are more equal than others': Patient-centred care differential in two-tier inpatient ward hospitals in Ghana

Objective: To examine differences in patient-centred care among private and public inpatients in public hospitals and whether satisfaction with patient-centred care differ between the patient groups. Method: Cross-sectional data collected from inpatients in private wards (n = 300) and public wards (n = 520) in Ghana, using a structured questionnaire modelled on four dimensions of patient-centred care: respect and dignity, emotional support, interpersonal relations and information sharing. Results: Patient-centred care differed significantly among private and public patients (p < 0.001), with an effect size ranging from medium to large. Private patients rated patient-centred care higher than public patients in all the items of the four dimensions. Satisfaction with patient-centred care discriminated between the patient groups. Satisfaction was significantly high for private patients who are aged 50+ (p < 0.001), had high education (p < 0.05) and high income (p < 0.001) compared to the same category of public patients. Conclusion: Physicians behaviour is stereotyping and less favourable to public patients, suggesting inequitable access to patient-centred care for inpatients from high and low socioeconomic backgrounds. Practice implications: Hospitals with private and public wards should be compelled to properly coordinate and regulate the activities of physicians to avoid fragmented care for inpatients.