Primary eyecare in paediatrics population (PREPP) - II study: Study of satisfaction of services and barrier for not reporting to the base hospital on referral among pediatric patients treated in six major vision centers of a tertiary eye care facility in Southern India

Abstract

Purpose: This study was conducted in continuation of Primary Eyecare in Paediatrics Population (PREPP-I) and was aimed to assess parents' satisfaction with pediatric-eye-care services across six vision centers (VCs) of a tertiary eye hospital in Southern India. The barriers among the parents for not attending the base hospital (BH) when referred from these VCs were also evaluated.

Methods: A standard-validated-satisfaction questionnaire (VSQ) was used to assess patient satisfaction. Responses were assessed on a 5-point Likert scale: 0 (very dissatisfied) to 4 (very satisfied) against each response. Responses were expressed as percentages with 0 (very dissatisfied) and 100% (very satisfied). Patients were referred with a form mentioning reasons for referral (urgent/non-urgent). All referrals were evaluated by the principal investigator. In case of failure to report, parents were enquired about the barrier based on the validated barrier questionnaire (VBQ) over a telephonic conversation.

Results: All 250 patients of the PREPP-1 study were included in the satisfaction study. Different domains were evaluated using VSQ (accessibility of VC, waiting hours, financial aspects, spectacle dispensing service, and teleophthalmology). The overall satisfaction was 75%. The most common reason for dissatisfaction was the lack of meeting the ophthalmologist in person, followed by waiting time. 58 patients wanted to visit BH to consult a pediatric ophthalmologist in person (23%). For the barrier study, 14 out of 47 referrals did not report and were evaluated using VBQ (knowledge, physical, time, and financial barriers). The majority had a financial barrier (43%), followed by knowledge (28.6%) and time barrier (14%).

Conclusion: PREPP-II demonstrated that 3/4 th of pediatric patients are happy to be treated at VC with teleophthalmology services. However, a significant percentage want to consult a specialist at BH. One-fourth of total referrals did not report to BH due to financial constraints and a lack of awareness of the child's condition.

Figure 1

Bar diagram showing the percentage of different types of barriers in case of not reporting to the BH

Figure 2

Pie chart showing the various categories of barrier factors for not reporting to the BH on referral