Determining patient expectations in health services delivery

Patient expectation is a prediction of what will occur during or as a result of medical treatment. With its primary objective of determining patient expectations, the study has two objectives. The first is to create a comprehensive patient expectation model by reviewing the patient expectations literature. The second is to determine what the patients to be served in the cardiology clinic expect and from who they have expectations through health service delivery and to test the patient expectations model. The study first made a systematic review of the relevant national (i.e. Turkish) and international literature published from 2009 to 2018 in order to create a patient expectations model. In this context, 5854 publications on patient expectations were determined, and 62 articles found to comply with the inclusion and exclusion criteria were examined by the PRISMA method. As a result of the examination, patient expectations were grouped under 22 categories, seven themes (access to service, communication, information, support, maintaining patient dignity, hospitality services, and expectations from treatment outcome), and four dimensions (expectations from the health establishment, expectations from doctors, expectations from nurses, and expectations from the treatment & care process). In this process, issues concerning patient expectations were identified, and a patient expectations model was developed based on the literature. Also, a semi-structured interview form, which was used as a data collection tool in the study, was created using the information contained in the literature. Field study was conducted on patients diagnosed with chronic diseases who would receive inpatient service from the cardiovascular clinic of a training and research hospital in Turkey from October 12 to November 13 in 2020. Using the interview form, data were collected from 19 of 26 patients hospitalized in the clinic within the said period. The data were subjected to directed content analysis using the NVivo program. The research found that patient expectations fall under seven themes and 23 categories. Among the patient expectation categories, doctor-patient communication, emotional support, nurse-patient communication, medical care, competence, treatment follow-up, and information in the treatment process are the most emphasized categories by the patients. The least emphasized expectation categories are social well-being and coordination/consultation. The literature-based patient expectations model is consistent with the cardiology patients' expectations; however, the patients do not hold expectations regarding the cost category in the model. On the other hand, they hold expectations regarding social well-being and communication with healthcare professionals other than doctors and nurses. As a result, the expectations of patients with cardiovascular diseases from health services in terms of treatment, care process, and treatment outcome are generally in line with the developed model. Just the social well-being and communication expectations replace the cost category in the model. Additionally, patients attach more importance to communication, emotional support, and medical care. It is expected that planning health services delivery taking into account the patient expectations and providing appropriate service to patients that will meet their expectations will improve patient compliance with the treatment and patient satisfaction with the hospital. Furthermore, conducting similar studies on different populations and samples is important to provide data that can be used in the development of health policies for the future.