Strengthening quality of acute care through feedback from patients in Ghana

Introduction Quality of acute care has attracted attention in recent years with policy initiatives in Ghana. Such initiatives need to be complemented with patient feedback systems for strengthening quality. Therefore the goal of this study is to examine factors associated with quality of acute care and to propose a range of options for improving the existing model of healthcare delivery. Methods Cross-sectional data were collected from 379 patients presenting to emergency centres in five public health facilities. A structured questionnaire developed based on the literature and expert advice by physicians and nurses was used to collect data. Principal component analysis (PCA) was used to extract the factors salient to patients' perspective of quality of care. Logistic regression was then used to examine association between these factors and overall quality of acute care. Results The majority of the patients (17.2%) presented with obstetrical related conditions, 15% with Road Traffic Accidents (RTAs), 11.3% with diarrhoea related problems and the least number (8.4%) with bronchial asthma. The average days of admission was high for patients with bronchial asthma (mean = 9), RTA (mean = 8) and burns (means = 7). The PCA produced four factors of quality (interpersonal care; prompt care; physical environment and privacy; drugs and equipment) all of which had a positive statistically significant association with overall quality of acute care after controlling for patient's socio-demographic characteristics. Conclusion Study findings provide important feedback not only for optimising clinical operations but also for improving in-hospital quality of acute care with short-term and long-term approaches.