Evaluation of Outpatient Access to the Greek Health System Considering the Constraints of the COVID-19 Pandemic.

Background The COVID-19 pandemic fundamentally changed the way healthcare is delivered in most healthcare systems around the world. It is now known that, in addition to the medical and economic impact of the pandemic on societies, there is another unmet medical need due to the difficulties and barriers that have existed and may still exist in the provision of health services at the primary care level in public hospitals. In Greece, there appears to have been a similar problem in citizens' access to health care in the country's public hospitals, which negatively affected the satisfaction of outpatients and significantly prevented them from receiving the medical care they needed.  Methods This study relied on two international questionnaires; the Visit Specific Satisfaction (VSQ-9), an instrument measuring patients' satisfaction with their visit to the physician, and the Patient Satisfaction Questionnaire Short-Form (PSQ-18), consisting of 18 questions measuring both satisfaction and dissatisfaction. The questionnaires were collected electronically between 01.03.22 and 20.03.22 from two hundred and three outpatient residents of the region of Eastern Macedonia and Thrace in Greece. Results The results of the study show that satisfaction of hospital outpatient department users is positively influenced by both access to medical care after the last visit (p=0.008 < 0.05) and frequency of visits (Pearson correlation coefficient=0.178, p=0.012). In addition, lower satisfaction with access to care was found among participants with the lowest income (p=0.010) and those with a chronic illness (p=0.002), which was attributed to pandemic limitations in access to health care services in public hospital outpatient departments. Regarding the overall satisfaction of participants, 40.9% were dissatisfied, and 32.5% were dissatisfied with specific hospital services. Conclusions It was found that patients were hindered from accessing medical care in the hospital due to the restrictions caused by the pandemic. This seemed to cause problems both in accessing a specialist and in making appointments. Half of the outpatients in the sample reported having difficulty communicating with the hospital to make an appointment or to access medical services in general. A relationship was also found between patient satisfaction and the quality of services provided, in terms of medical services offered, such as their availability, and patient satisfaction with the appropriate information they receive from physicians during the pandemic period. The study also found that long-term care hospitals need to improve patient satisfaction with existing medical services.