Abstract

Donabedian model health care quality assessment measures the difference between expected and actual performance to identify gaps in the health care system, which would serve as a starting point for quality improvement activities. So, the aim of this study was to assess the level of quality of health care with respect to structural settings, actual process of care, and outcomes of care. Institutional based both quantitative and qualitative cross-sectional study design was conducted. 735 patients selected using a multi-stage sampling method from randomly selected public health institutions of East Gojjam zone. Data were collected using semi structured interview questions and observational checklist adapted from national guidelines as a quality indicator of the Donabedian health service quality framework. Data were entered into SPSS version 20 for analysis. Bivariate and multivariate logistic regression was fitted to selects associated factors. The studied health institution fulfilled 137 (73.3%) of major equipment requirement against the national standard, diagnosis with treatment based on guideline rated (56.7%), nursing care rated (40%), and average satisfaction level of patients with given care is 39.7%. Residence, standard healthcare facilities, health workers' communication, and accessibility of health facility have significant association with patient satisfaction. This study found that quality of care in health facility is rated as poor against national standards. Promoting quality healthcare communication at all levels of health facilities is important. Minister of health and regional health bureau must ensure the accessibility of per standard healthcare facilities to improve outcomes of health care.

Key words: Donabedian, East Gojjam, Ethiopia, quality of care.

Abbreviation

FMOH, Federal Ministry of Health; GPS, general practitioners; IRERC, Institutional Research Ethics Review Committee; NGOs, Non-Governmental Organization; PMTCT, prevention of mother to child transmission of HIV; SPSS, Statistical Package of Social Science.