{"title":"探索在阿拉木图，哈萨克斯坦参保和未参保妇女对妇产科护理满意度的差异：一项比较横断面研究。","authors":"Sholpan Aliyeva, Vyacheslav Lokshin, Maksut Kamaliev, Sholpan Sarmuldayeva, Gani Kaldybayev, Oxana Tsigengagel","doi":"10.3389/fgwh.2025.1580888","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Patient satisfaction is a key indicator of healthcare quality. Although crucial, limited research has explored factors contributing to satisfaction disparities in outpatient obstetric-gynecological care, particularly in Kazakhstan. The objective of the study is to explore disparities in satisfaction with obstetric-gynecological care between insured and uninsured women in Almaty, Kazakhstan, and to identify the key determinants of patient satisfaction.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 107 insured and uninsured patients over three months in early 2024 at a hospital in the Almaty region, Kazakhstan. Using a five-point Likert scale, a structured questionnaire assessed socio-demographics, patient-reported experiences with the care process, and overall satisfaction across 16 dimensions. The survey instrument was pilot-tested and demonstrated strong internal consistency (Cronbach's alpha = 0.83). Chi-square tests examined associations, and multivariable logistic regression identified key predictors of patient satisfaction.</p><p><strong>Results: </strong>A multivariable analysis revealed a \"satisfaction paradox\": insured patients had lower odds of being satisfied compared to uninsured patients (AOR = 0.15, 95% CI: 0.03-0.81). Specifically, a lack of insurance was associated with higher reported satisfaction in doctor-patient communication (OR = 1.8) and nursing care (OR = 2.1). Other significant predictors of satisfaction included having kidney disease and a shorter hospital stay.</p><p><strong>Conclusions: </strong>Our findings suggest that expanding insurance coverage is necessary for access but insufficient for ensuring patient satisfaction. The observed \"satisfaction paradox\" highlights that policy must adopt a dual focus: promoting enrolment while simultaneously improving the quality of patient-provider interactions to meet the higher expectations of insured patients.</p>","PeriodicalId":73087,"journal":{"name":"Frontiers in global women's health","volume":"6 ","pages":"1580888"},"PeriodicalIF":2.4000,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331730/pdf/","citationCount":"0","resultStr":"{\"title\":\"Exploring disparities in satisfaction with obstetric-gynecological care among insured and uninsured women in Almaty, Kazakhstan: a comparative cross-sectional study.\",\"authors\":\"Sholpan Aliyeva, Vyacheslav Lokshin, Maksut Kamaliev, Sholpan Sarmuldayeva, Gani Kaldybayev, Oxana Tsigengagel\",\"doi\":\"10.3389/fgwh.2025.1580888\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Patient satisfaction is a key indicator of healthcare quality. Although crucial, limited research has explored factors contributing to satisfaction disparities in outpatient obstetric-gynecological care, particularly in Kazakhstan. The objective of the study is to explore disparities in satisfaction with obstetric-gynecological care between insured and uninsured women in Almaty, Kazakhstan, and to identify the key determinants of patient satisfaction.</p><p><strong>Methods: </strong>A cross-sectional survey was conducted among 107 insured and uninsured patients over three months in early 2024 at a hospital in the Almaty region, Kazakhstan. Using a five-point Likert scale, a structured questionnaire assessed socio-demographics, patient-reported experiences with the care process, and overall satisfaction across 16 dimensions. The survey instrument was pilot-tested and demonstrated strong internal consistency (Cronbach's alpha = 0.83). Chi-square tests examined associations, and multivariable logistic regression identified key predictors of patient satisfaction.</p><p><strong>Results: </strong>A multivariable analysis revealed a \\\"satisfaction paradox\\\": insured patients had lower odds of being satisfied compared to uninsured patients (AOR = 0.15, 95% CI: 0.03-0.81). Specifically, a lack of insurance was associated with higher reported satisfaction in doctor-patient communication (OR = 1.8) and nursing care (OR = 2.1). Other significant predictors of satisfaction included having kidney disease and a shorter hospital stay.</p><p><strong>Conclusions: </strong>Our findings suggest that expanding insurance coverage is necessary for access but insufficient for ensuring patient satisfaction. The observed \\\"satisfaction paradox\\\" highlights that policy must adopt a dual focus: promoting enrolment while simultaneously improving the quality of patient-provider interactions to meet the higher expectations of insured patients.</p>\",\"PeriodicalId\":73087,\"journal\":{\"name\":\"Frontiers in global women's health\",\"volume\":\"6 \",\"pages\":\"1580888\"},\"PeriodicalIF\":2.4000,\"publicationDate\":\"2025-07-25\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12331730/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Frontiers in global women's health\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.3389/fgwh.2025.1580888\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/1/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q2\",\"JCRName\":\"OBSTETRICS & GYNECOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Frontiers in global women's health","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.3389/fgwh.2025.1580888","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/1/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"OBSTETRICS & GYNECOLOGY","Score":null,"Total":0}
Exploring disparities in satisfaction with obstetric-gynecological care among insured and uninsured women in Almaty, Kazakhstan: a comparative cross-sectional study.
Background: Patient satisfaction is a key indicator of healthcare quality. Although crucial, limited research has explored factors contributing to satisfaction disparities in outpatient obstetric-gynecological care, particularly in Kazakhstan. The objective of the study is to explore disparities in satisfaction with obstetric-gynecological care between insured and uninsured women in Almaty, Kazakhstan, and to identify the key determinants of patient satisfaction.
Methods: A cross-sectional survey was conducted among 107 insured and uninsured patients over three months in early 2024 at a hospital in the Almaty region, Kazakhstan. Using a five-point Likert scale, a structured questionnaire assessed socio-demographics, patient-reported experiences with the care process, and overall satisfaction across 16 dimensions. The survey instrument was pilot-tested and demonstrated strong internal consistency (Cronbach's alpha = 0.83). Chi-square tests examined associations, and multivariable logistic regression identified key predictors of patient satisfaction.
Results: A multivariable analysis revealed a "satisfaction paradox": insured patients had lower odds of being satisfied compared to uninsured patients (AOR = 0.15, 95% CI: 0.03-0.81). Specifically, a lack of insurance was associated with higher reported satisfaction in doctor-patient communication (OR = 1.8) and nursing care (OR = 2.1). Other significant predictors of satisfaction included having kidney disease and a shorter hospital stay.
Conclusions: Our findings suggest that expanding insurance coverage is necessary for access but insufficient for ensuring patient satisfaction. The observed "satisfaction paradox" highlights that policy must adopt a dual focus: promoting enrolment while simultaneously improving the quality of patient-provider interactions to meet the higher expectations of insured patients.
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