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International Journal for Quality in Health Care Advance Access published online on June 28, 2005
International Journal for Quality in Health Care, doi:10.1093/intqhc/mzi062
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International Journal for Quality in Health Care © The Author 2005. Published by Oxford University Press on behalf of International Society for Quality in Health Care; all rights reserved
Accepted May 26, 2005

Article

Patient satisfaction with health care providers in South Africa: the influences of race and socioeconomic status

Neil G. Myburgh 1, Geetesh C. Solanki 2, Matthew J. Smith 3, and Ratilal Lalloo 1*

1 Community Oral Health, University of the Western Cape, Cape Town, Western Cape, South Africa
2 Fifth Quadrant Actuaries and Consultants, Cape Town, Western Cape, South Africa
3 Strategy and Tactics, Cape Town, Western Cape, South Africa

* To whom correspondence should be addressed.
Ratilal Lalloo, E-mail: rlalloo{at}uwc.ac.za


  Abstract

Objective. The first democratic government elected in South Africa in 1994 inherited huge inequalities in health status and health provision across all sections of the population. This study set out to assess, 4 years later, the influence of race and socio-economic status (SES) on perceived quality of care from health care providers.

Design. A 1998 countrywide survey of 3820 households assessed many aspects of health care delivery, including levels of satisfaction with health care providers among different segments of South African society.

Results. Fifty-one percent (n = 1953) of the respondents had attended a primary care facility in the year preceding the interview and were retained in the analysis. Both race and SES were significant predictors of levels of satisfaction with the services of the health care provider, after adjusting for gender, age, and type of facility visited. White and high SES respondents were about 1.5 times more likely to report excellent service compared with Black and low SES respondents, respectively.

Conclusions. The usefulness of these measures will depend on whether the concept of intensity of care near death can be further validated as an acceptable and important quality issue among patients, their families, health care providers, and other stake-holders in oncology.

Conclusion. In South Africa, race and SES are not synonymous and can no longer be considered reliable proxy indicators of one another. Each has distinct and significant but different degrees of association with client satisfaction. Any assessment of equity-driven health policy in South Africa should consider the impacts of both race and SES on client satisfaction as one of the indicators of success.

Keywords: equality, health care provider, health policy, patient satisfaction, race, socioeconomic status, South Africa.
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