The Effects of Underbudgeting of Public Hospitals on the Level of Out-of-Pocket Expenditures, Socio-Economic Impact and Patient Satisfaction on Hospital Services

Abstract

The public spending on health has a large impact on patient satisfaction simply because health services are perceived to be provided free of charge by the state. By introducing of new health law in 2012, Kosovo Ministry of Health aimed to the reform entire health sector including reform of financing of the health sector. This research has been conducted in different units of General Hospital of Gjilan/ Kosovo. A questionnaire consisting of 30 questions has been applied aiming to analyze several aspects including patient demographic data, length of health worker daily activities with patients and availability of services, general satisfaction with medical service and medical care, technical quality, communication, general patient satisfaction of hospital hygiene, out-of-pocket payments and the nature of this expenditure. All respondents have given high grades to the physicians and to the nurses; there were no significant differences in the perception of the quality of hospital services from the perspective of all four analyzed constants. Results have proven a significant negative correlation between out-of-pocket expenditures and financial and patients’ social burden. The results of our research have demonstrated that the patient satisfaction with hospital services provided were correlated to several factors including physicians and nurses’ engagements with patients, access to the hospital facilities, the effectiveness of hospital administration, technical services, and hospital environment as are ward conditions, hygiene, and patient privacy. The study has emphasized the main key to solving hospital shortages is adequate and sustainable budgeting. Current level of public financing is not covering all hospital needs and is also related to a low level of GDP for health.