Analysis of Risk Factors for the Quality of Health Services in Primary Health Facilities: An Observational Study in North Bengkulu Regency, Indonesia

Abstract

Primary health care (PHC) is crucial for overall health system performance, particularly in developing nations. However, variations in the quality of PHC services in Indonesia, particularly in North Bengkulu Regency, raise concerns. This study aimed to identify and analyze risk factors associated with suboptimal quality of health services in these facilities. This observational, cross-sectional study was conducted in 20 primary health centers (PHCs) in North Bengkulu Regency. A multi-stage random sampling technique was used to select 400 patients and 80 healthcare providers. Data were collected using validated questionnaires assessing various dimensions of service quality (tangibles, reliability, responsiveness, assurance, and empathy), patient satisfaction, and potential risk factors (socio-demographic, facility-related, and provider-related). Descriptive statistics, bivariate analysis, and multivariate logistic regression were used for data analysis. The study found a significant association between perceived service quality and patient satisfaction. Socio-demographic factors (lower education and income), facility-related factors (inadequate staffing and lack of essential medicines), and provider-related factors (insufficient communication and perceived lack of empathy) were identified as risk factors for lower service quality. The quality of health services in North Bengkulu PHCs is influenced by a complex interplay of patient, facility, and provider factors. Interventions targeting these risk factors, such as community education, capacity building for providers, and improvements in resource allocation, may improve PHC service quality and patient satisfaction in this region.