Exploring patient perspectives: A qualitative inquiry into healthcare perceptions, experiences and satisfaction in Lebanon

• Published in: PloS one 2023-08, Vol.18 (8), p.e0280665-e0280665
• Main Authors: Khalife, Jade, Ekman, Björn, Ammar, Walid, El-Jardali, Fadi, Al Halabi, Abeer, Barakat, Elise, Emmelin, Maria
• Format: Article
• Language: English
• Subjects: Biology and Life Sciences; Content analysis; Evaluation; Health care; Health care access; Health care industry; Health care policy; Health Care Service and Management, Health Policy and Services and Health Economy; Health insurance; Health Sciences; Health services; Hospitalization; Hospitals; Humans; Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi; Hälsovetenskap; Lebanon; Medical and Health Sciences; Medical care; Medicin och hälsovetenskap; Medicine and Health Sciences; Patient Satisfaction; Patients; Pay for performance; People and Places; Perceptions; Personal Satisfaction; Public health; Qualitative analysis; Qualitative Research; Quality management; Reimbursement, Incentive; Social Sciences; Women
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0280665

Patient perspectives have received increasing importance within health systems over the past four decades. Measures of patient experience and satisfaction are commonly used. However, these measures do not capture all the information that is available through engaging with patients. An improved understanding of the various types of patient perspectives and the distinctions between them is needed. The lack of such knowledge limits the usefulness of including patient perspectives as components within pay-for-performance initiatives. This study aimed to explore patient perspectives on hospital care in Lebanon. It also aimed to contribute insights that may improve the national pay-for-performance initiative and to the knowledge on engaging patients towards person-centered health systems. We conducted a qualitative study using focus group discussions with persons recently discharged after hospitalization under the coverage of the Lebanese Ministry of Public Health. This study was implemented in 2017 and involved 42 participants across eight focus groups. Qualitative content analysis was used to analyze the information provided by participants. Five overall themes supported by 17 categories were identified, capturing the meaning of the participants' perspectives: health is everything; being turned into second class citizens; money and personal connections make all the difference; wanting to be treated with dignity and respect; and tolerating letdown, for the sake of right treatment. The most frequently prioritized statement in a ranking exercise regarding patient satisfaction was regular contact with the patient's doctor. Patient perspectives include more than what is traditionally incorporated in measures of patient satisfaction and experience. Patient valuing of health and their perceptions on each of the health system, and access and quality of care should also be taken into account. Hospital pay-for-performance initiatives can be made more responsive through a broader consideration of these perspectives. More broadly, health systems would benefit from wider engagement of patients. We propose a framework relating patient perspectives to value-based healthcare and health system performance.