2023-11-01-世界银行-利用满意度调查改进向哥斯达黎加人民提供卫生服务的情况（英）_7页_365kb

Summary of Knowledge Brief: Satisfaction Surveys for Improving Health Services in Costa Rica

Executive Summary

This knowledge brief examines the use of patient satisfaction surveys by the Costa Rican Social Security Fund (CCSS) to enhance health service delivery. The surveys, based on the SERVQUAL model, were successfully implemented from 2016 to 2023 with support from the World Bank's Program for Results (PforR). Key outcomes include improved user perceptions, increased staff engagement, and institutional changes, despite challenges like the COVID-19 pandemic and low response rates.

Key Findings

• Satisfaction surveys have positively impacted user perceptions of hospitalization and outpatient services, with consistent application over five years.
• The surveys were redesigned in 2016 to align with user priorities, incorporating indigenous populations and using models like Net Promoter Score (NPS) for comprehensive evaluation.
• Implementation fostered a culture of quality improvement, with clear improvement plans based on satisfaction data, leading to better service alignment and recognition of high-performing units.

Methodology and Implementation

• The surveys utilized the SERVQUAL model, measuring five dimensions of service quality, and were conducted annually by third-party experts like CID Gallup.
• Post-redesign, the surveys were executed via telephone, ensuring broader reach and data on vulnerable groups. Integration into the CCSS involved cross-departmental collaboration and a dedicated improvement process.

Outcomes and Impact

• Positive results include enhanced user trust, better service comparisons, visibility of indigenous user needs, and institutional commitment to continuous improvement.
• Evidence of success includes high survey participation rates and alignment of quality plans with user feedback.

Challenges and Solutions

• Challenges included bureaucratic delays in contracting survey providers, resistance from health units, low response rates, and external disruptions like COVID-19 and cyber-attacks.
• Solutions involved proactive planning, transparent third-party execution, adapting methodologies (e.g., reweighting questionnaire indicators), and maintaining focus through institutional support.

Lessons Learned and Recommendations

• Essential steps include consulting users early, ensuring adequate funding and political will, and tailoring tools to local contexts.
• Future efforts focus on sustaining the surveys, redesigning questionnaires to address emerging services, and strengthening the translation of results into actionable improvement plans to ensure lasting impact on user satisfaction.