Original communication
Analysis of complaints lodged by patients attending a university hospital: A 4-year analysis

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Abstract

Objective

Health practitioners often regard complaints concerning the quality of patient care in a negative light. However, complaints by patients and their relatives are an important source of information when considering ways in which to improve care. In the present study, we evaluated the complaints of patients and their relatives with regard to our hospital, such that we could take adequate remedial measures.

Method

Records of all patient complaints made between June 2008 and June 2012 were retrieved from the archives of the Quality Improvement Unit. The socio-demographic profiles of complainants, and their reasons for complaining, were analyzed using the SPSS statistical package.

Results

The results revealed that 453 complaints, relating to medical care, the attitude of staff, waiting times, and financial issues, were made against our hospital over 4 years. Of the complainants, 68.9% (n = 312) were male, and 31.1% (n = 141) were female. The majority (16.3% and 20.4%, respectively) of the complaints were due to medical care and staff attitude problems. The unit about which most patients complained was hospital administration (22.1%), and one hundred fifty-three (33.8%) complaints were about physicians. Complaint frequency was 0.22 per 1.000 visits.

Conclusion

Complaints may be potentially useful quality assurance tools, and can identify system flaws. The primary causes of complaints were medical care, attitude of the staff, and waiting time, and many of these issues may be remedied.

Introduction

Consumers are becoming increasingly well informed and more aware of their rights, leading to a rise in complaints about the quality of healthcare. Therefore, it is necessary to encourage further research to ensure more appropriate use of patient complaints, with the aim of improving healthcare services.

Patients complain for a variety of reasons if they become dissatisfied with the service they are receiving. These complaints may result from unmet expectations, or may reflect poor service quality. Health practitioners often perceive them in a negative light, and complaints can sometimes have a devastating effect on individuals and organizations. However, complaints can be viewed positively; they act as a benchmark to assess quality of care, as well as highlight the need to make interventions to rectify issues, and thereby minimize the number of future complaints. Quantitative measurement of patient complaints is a comparative measure of service quality, and several authorities believe that quality assurance measures should include patient satisfaction and an analysis of patient complaints.1 However, it is evident that hospitals do not use patient complaints as a source of learning to promote higher standards of care.2

Our hospital has 940 beds, as well as three intensive care units that contain 110 beds, and approximately 500,000 patients are admitted annually. We analyzed data regarding patient complaints that were made between June 2008 and June 2012. The study aimed to determine the rate of complaints, their nature, and the profile of the people who lodged them, so that steps can be taken to minimize the number of complaints made in the future.

Section snippets

Methods

The study entailed a retrospective analysis of complaints relating to the care of patients treated in xxxxxxxx University Hospital, between 1 June 2008 and 1 June 2012, and was approved by the Medical Ethics Committee of xxxxxxxx University.

In May 2004, the hospital set up a complaints department that deals with all complaints, whether made verbally, in writing, by telephone, or through other forms of electronic communication, received by the Health Ministry Communication Center (HMCC) and the

Results

Between 1 June 2008 and 1 June 2012, 2,031,361 patients were admitted, and the hospital received 489 complaints. Of the complaints, 36 were excluded from the study, since the data relating to them were not completely understood.

Of the complaints received, 410 were made to the QIU, 23 to the HMCC, and 17 to the PMCC. In addition, three complaints were made using the hospital email address. Of the complainants, 312 (68.9%) were male and 141 (31.1%) were female (Table 1). The majority of

Discussion

A complaint is a condition or expression of dissatisfaction with, for example, staff, procedures, fees, and quality of care. In the present study, we investigated the proportion of admissions that were associated with written and electronic complaints, the type of complaint, their nature, and the profile of the people who lodged them over a 48-month period.

Other investigators have reported complaint rates ranging from 1.12 to 8 complaints/1000 patients. For example, Anderson et al. found this

Limitations

The present study has several limitations. First, complaints are often complex and some may have been incorrectly categorized, leading to measurement bias. There is no objective standard available to classify complaints. Second, the results are subject to selection bias. It is possible that some complaints were not passed on to hospital complaint department officers, and that the data underrepresent the true complaint rates.

Conclusion

The primary causes of the complaints received were insufficient medical care, inappropriate attitude of staff, and long waiting time. Complaints may be potentially useful quality assurance tools. A study of complaints may help identify gaps in our services, allowing for necessary corrections to policies or procedures.

Ethical approval

None declared.

Funding

None declared.

Conflict of interest

The author(s) certify that they have no affiliation with or financial involvement in any organization or entity with a direct financial interest in the subject matter or materials discussed in the manuscript. The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Acknowledgement

We thank to Levent Elbeyli and Belgin Alaşehirli for their kind generous help.

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