Patient satisfaction with ambulatory care services delivery and respect for patient rights: findings from 2022 national survey in Rwanda

Background This study evaluated the factors influencing patient satisfaction with hospital services and respect for patient rights in outpatient consultation in Rwanda, aiming to provide insights into improving the overall quality of care. Methods This was cross-sectional study design. We recruited participants from all (30) districts in Rwanda using stratified sampling. A structured questionnaire assessed satisfaction across seven hospital areas, including cashier, waiting, triage, doctor consultation, laboratory, pharmacy, and respect for patient rights. We used descriptive statistics, Chi-square, and Multivariate Regression analyses. Results The study showed that most participants expressed satisfaction with hospital services and respect for their rights: doctor consultations (93.8%), triage (92.0%), dispensing pharmacy (88.2%), laboratory services (87.2%), waiting area (85.3%), patient rights (74.3%), cashier services (73.3%). At bivariate analysis, we observed that satisfaction in waiting areas was associated with location ( p = 0.036), provinces (p < 0.001), and hospital rank (p < 0.001), while satisfaction in triage was associated with age categories (p < 0.001) and visits ( p = 0.02). The association of satisfaction in cashier services with age categories (p < 0.001), visits (p = 0.032), and hospital rank (p = 0.005) was also significant, as well as satisfaction in dispensing pharmacy and provinces (p < 0.001), location (p = 0.002), and visits (p = 0.008). Multiple logistic regression indicated higher satisfaction in waiting areas among patients from Northern (OR = 3.81, 95%CI = 1.85-5.64), Western (OR = 1.95, 95%CI = 1.48-3.60), and Southern provinces (OR = 1.93, 95%CI = 1.17-2.85), while urban patients (OR = 0.65, 95%CI = 0.47-0.91) and those from high-rank hospitals had lower satisfaction (OR = 0.59, 95%CI = 0.43-0.82). High-rank hospital patients were more satisfied with triage (OR = 1.86, 95% CI = 1.14-3.13) while returning patients were less satisfied (OR = 0.51, 95%CI = 0.33-0.90). Lower satisfaction in dispensing pharmacy was observed among the City of Kigali (OR = 0.11, 95%CI = 0.05-0.24), Northern province (OR = 0.43, 95%CI = 0.23-0.80), and returning patients (OR = 0.51, 95%CI = 0.33-0.76). Urban (OR = 2.5, 95%CI = 1.32-5.16) and high-rank hospital patients (OR = 1.96, 95%CI = 1.08-3.77) reported higher laboratory satisfaction. However, cashier services had lower satisfaction among Kigali (OR = 0.37, 95%CI = 0.21-0.64), Northern (OR = 0.44, 95%CI = 0.29-0.65), and Western province patients(OR = 0.63, 95%CI = 0.43-0.91), returning patients (OR = 0.73, 95%CI = 0.55-0.96), and those from high-rank hospitals(OR = 0.70, 95%CI = 0.54-0.92). Conclusion Our study has revealed disparities in satisfaction with ambulatory care services delivery by provinces, hospital rank and visit status. We recommend hospital to take initiatives aiming at streamlining payments, optimizing waiting area services, and enhancing coordination, staff training, regional equity, and patient-centered policies for continuous service improvement.