Patient's perspective of outpatient clinic services delivery during Covid-19 outbreak in East-Jerusalem
Firas zeyad Abdulqader Daghlas
فراس زياد عبد القادر دغلس
Background: Corona viruses are called zoonotic viruses that are transmitted from animals to humans, at the end of 2019, the appearance of a new Coronavirus disease COVID-19 in Wuhan China. The state of emergency was declared by Palestinian Minister of Health in 5 march 2020, and in 11 March 2020, the 'World Health Organization' (WHO) declared COVID-19 as a "pandemic". The COVID-19 pandemic has the same implications on health system due to reduced accessibility and availability of health resources. During COVID-19 pandemic the quality of care suffered and the virus stretched some health systems to breaking point and intensive care units being overwhelmed. Patient's attitude toward healthcare has shifted during COVID-19 pandemic, and out-patients have reduced their regular visits to the clinics. Understanding of patient's preference leads the care to be cheaper, more effective and closer to the individuals' desires. The COVID-19 morbidity and mortality indicators were higher in Palestine in comparison with the global level. Furthermore, social gathering and lack of readiness of the fragmented health system were risk factors in the spread of COVID-19. Aim: To assess the patient's perspective of outpatient clinics services delivery during COVID-19 outbreak in East-Jerusalem. Methodology: A cross sectional study was conducted by using convenience sampling technique and self-administered questionnaires which consisted of the socio-demographic data sheet and patient's perspective of health care system delivery on accessibility, availability of resources quality of care, and patient's attitude and preferences during COVID-19 outbreak scale which developed based on Jadoo (2014) study. The sample included 300 participants from outpatient clinics in East- Jerusalem hospitals which were Al-Makassed hospital, Augusta Victoria Hospital and Saint-Joseph hospital. Statistical analysis was done using T-test, one-way ANOVA, the statistical significance was defined as a P-value of (0.05). Results: The results showed that the most of the participants (98.6%) had negative opinion when the current situation is compared with before the COVID-19 period in terms of accessibility, availability of resources, quality of care, attitudes and patient's preference. Only 5.55% of participants had a positive opinion regarding the preference of the health care system during the COVID-19 outbreak. The relationship between the dependent and IV the independent variables showed that there was a statistically significant relationship between patient's perspectives of health care system delivery items and occupation, pvalue is equal to 0.036(α ≤ 0.05). Moreover, there was no significant relationship between medical history variables and patients‘ perspectives, since (α ≤ 0.05). Multivariate analysis indicated that there was no significant relationship between occupation and participant's opinion (p= 0.089) prevalence odds ratio [POR] = 1.98, 95%CI 1.225-3.215). Conclusion: This study revealed that the most of the participants had a negative opinion when the current situation is compared with before the COVID-19 period in terms of accessibility, availability of resources, quality of care, attitudes and the patient's preference. Only 5.55% of participants had a positive opinion regarding the preference of the health care system during the COVID-19 outbreak. Most of the participants reported that there is a decrease in the accessibility to health services that were provided during the COVID-19 outbreak in East Jerusalem. Policy makers should pay attention to the accessibility to health care, availability of health resources, quality of healthcare, patient's attitudes and patient's preference during COVID-19 pandemic and other pandemics. Also, policymakers should investigate the reasons behind increased waiting time and more money consuming to get health care services. Moreover, should pay attention to the importance of patient's perspective and their opinion in health care system which leads to better understanding of patients needs and preferences. There is a need to conduct a qualitative study to understand the issues in more detail ,the reasons why patients do not prefer the health services (now) during the COVID-19 outbreak period.