By: Teh Shi Ning

Survey highlights differences in private and public healthcare reports

RECESSION INDUCED change in patient demographics could explain the divergence between customer satisfaction levels at private and public hospitals here.
 
Singapore's healthcare sector is one of just two sectors where customers are now more satisfied than a year ago, the latest Custom er Satisfaction Index of Singapore (CSISG) 2009 shows.

But this improvement was largely driven by private hospitals specialist clinics and general practitioners. Restructured hospitals saw customer satisfaction trend in the opposite direction.

Other than Singapore General Hospital (SGH) and Tan Tock Seng Hospital (TTSH), which saw scores inch up a fraction of a point, customers of all other restructured hospitals were less satisfied last year than in 2008.

Alexandra Hospital chief executive Liak Teng Lit suggests two explanations relating to the downturn: a heavier patient load overall, and a larger proportion of patients from middle to high-income households. Alexandra Hospital s score dipped 1.6 points to 66.8 a slightly smaller fall than the 2.4 points fall registered by National University Hospital (NUH), Changi General Hospital (CGH) and KK Women & Children's Hospital.

Mr Liak says: "Last year, there was a lot of economic uncertainty, and generally the patient load at private hospitals fell while that in the public sector rose." This was partly due to a fall in medical tourism but caution and austerity also led some who would usually patron ise private hospitals to choose the more affordable public sector ones.

Though they switched for value, these newer customers retained higher expectations, which were not met and hence pulled down the restructured hospitals' scores. This was apparent from a breakdown of results by household income which showed that lower-income house holds which Alexandra focuses on serving - were happier with the service they got.

Mr Liak says he is not unduly worried nor defensive about the score, as Alexandra has fared very well in other patient satisfaction surveys. But the CSISG survey is useful and has given the hospital a "wake-up call" that middle to high-income customers are less satisfied with their service delivery, he says.

"We do need to look at the different customers who are coming to us now too. There are things we can do - extend opening hours, cut waiting times - though these have to be balanced with availability of resources."

Caroline Lim, director of the Institute of Service Excellence (ISES) at Singapore Management University (SMU) which compiles the index, thinks that this highlights the need for all companies, in healthcare or otherwise, to understand how changes in the make-up of their customer base might affect customers' expectations.

She thinks that this trend of changing patient profiles does not undermine the commendable improvement made by private hospitals, whose scores have rebounded after falling in 2008. "It was a matter of mooting expectations that enabled them to regain their standing whereas it was a perceived-quality-of-service issue that caused the fail earlier."

This meant that the private hospitals had taken measures to better match patients' expectations with what they delivered, Ms Lim says. Together, they gained 2.53 points to hit a score of 72.4. Outperforming the sub-sector score were Thomson Medical Centre, which scored 73.3 and Raffles Hospital, which scored 73.

Polyclinics made up the other healthcare grouping which Ms Lim thinks deserves recognition. The polyclinics' performance has risen steadily year-on-year. They have seen tremendous improvement - an average of three points a year and this came from them being better able to meet customers expectations, too.

The National Healthcare Group Polyclinics (NHGP) lifted its customer satisfaction score 1.51 points to 65.8 this year, closing the gap between itself and the other polyclinics group, SingHealth. Telephone surveys and mystery audits check consistency of service delivery at the group's nine polyclinics, and patient focus groups meet regularly to provide NHGP feedback.

An NHGP spokesman said: "It's a combination of understanding patient needs and improvements on facilities, care processes and service quality skills that improved our scores. The key is to ensure consistent service delivery and sustainable improvement.