ASSESSMENT OF PATIENT SATISFACTION REGARDING THE TIME REQUIRED TO INITIATE THE TREATMENT AND TIME TAKEN FOR DOCUMENTATION OF MEDICOLEGAL CASES AT THE EMERGENCY DEPARTMENT OF A RURAL GOVERNMENT HOSPITAL IN UTTAR PRADESH, INDIA

Abstract

Background: Patient safety has grown into a distinct healthcare discipline based on developing scientific knowledge. Patient satisfaction is a systematic approach to ensuring that health services use their resources to improve the population's health most efficiently. It addresses the patient's specific needs.

Aim: To assess patient satisfaction with treatment initiation time and documentation time of medico-legal cases in the emergency department of a rural government hospital by conducting a patient satisfaction survey.

Material and method: This prospective, observational survey study was conducted at the emergency and trauma department of  UPUMS, Saifai, Etawah, from February 2023 to August 2023 on 800 medicolegal patients requiring emergency care. This quantitative study included a questionnaire and a quality Likert scale response. A pilot study on 50 patients was conducted to determine the reliability of responses and validity of the questionnaires. After receiving approval from the scientific and ethical committee, a mixed-mode survey was carried out, including a written and an in-person face-to-face interview. Data collected was analysed on an ordinal measurement scale using nonparametric statistical methods.

Results: Patients were dissatisfied with treatment initiation time and the time taken for the medicolegal documentation process. For the time it took to start the treatment, more than half of the patients (62%) were dissatisfied, and only 31% were satisfied. The younger age group (18 to 41 years) opted very poor, 8% more than the older age group (42 to 65 years). Patients in the older age group were 11% more satisfied than patients in the younger age group. Perceptions of the quality of treatment initiation were almost the same in male and female patient groups (p = 0.440) but differed significantly in the age group (p <0.001). When asked about the time taken for medico-legal documentation, 39% of the patients did not comment. Of these, 53% were females. 42% of the 800 patients were dissatisfied, and only 19% were satisfied. There was a significant difference in perception (p=.011) between the gender groups but no significant difference (p=0.263) between the age groups. There is a significant correlation with Spearman’s rho coefficient of 0.939 between the time to start treatment and the documentation of Medco legal patients.

Conclusion: Delays in initiating treatment and documenting medico-legal cases are common in rural hospital emergency departments. Factors such as prehospital delay, triage process, human resources, transportation equipment, bed availability, and overcrowding contribute to this issue. Research is needed to identify effective solutions. Awareness, large-scale studies, and feedback mechanisms can improve patient safety culture.

Keywords: patient safety, satisfaction, medico-legal, documentation, emergency, nonparametric, ordinal