Introduction: Medical practitioners are the backbone of health systems. Professionals' assessment of the quality of healthcare varies depending on the type of healthcare system, their place in it, their professional experience, and their specialty.
Aim: The aim of the study is to investigate the relationships between the professional and contextual characteristics of medical specialists, and their assessment of the quality of healthcare in Bulgaria.
Materials and Methods: Data from a national sociological survey of 282 medical professionals conducted online in November 2021 were used. A χ2-test of independence was used to determine the existence of significant differences in the assessment of professionals according to their profession, length of their work experience, type and location of the medical facility in which they work. Independent-sample Student's t-test and one-factor analysis of variance (One-Way ANOVA) were conducted to test for statistically significant differences in assessment and defined contextual and professional characteristics.
Results: The majority of medical specialists assess the quality of healthcare in Bulgaria as satisfactory. An association was found between professionals with little work experience in healthcare and negative assessment of quality, ꭓ2 = 4.81, p = 0.028 < 0.05, N = 282. A statistically significant effect was observed between specialists who work in medical facilities in regional center towns, who assessed the quality as satisfactory ꭓ2 = 4.33, р = 0.037 < 0.05, N = 282, and specialists who work in Sofia, who assessed the quality of healthcare as bad ꭓ2 = 5.10, р = 0.024 < 0.05, N = 282.
Conclusion: The results of our study indicate that professional and contextual characteristics have some, but not significant, relationships with medical specialists’ assessment of the quality of healthcare in Bulgaria.
World Health Organization. Health workforce (HWF). The world health report 2006: Working together for health [Internet]. 2006. Available from: https://www.who.int/publications/i/item/9241563176
Massoud R, Askov K, Reinke J, Miller Franko L, Bornstein T, Knebel E, et al. A modern paradigm for improving healthcare quality. Center for Human Services; 2000.
Josiah BO, Enebeli EC, Duncan BA, Anukam LU, Akingbade O, Ncube F, Jet al. Perceptions of healthcare finance and system quality among Nigerian healthcare workers. PLOS Glob Public Health. 2024 Nov 7;4(11):e0003881. doi: 10.1371/journal.pgph.0003881.
Friedberg M. Relationships between physician professional satisfaction and patient safety. RAND; 2016 Feb 23. Available from: https://www.rand.org/pubs/commentary/2016/02/relationships-between-physician-professional-satisfaction.html
Ajmi SC, Aase K. Physicians’ clinical experience and its association with healthcare quality: a systematised review. BMJ Open Qual. 2021;10:e001545. doi:10.1136/bmjoq-2021-001545.
Ortiz-Prado E, Fors M, Henriquez-Trujillo AR, Cevallos-Sierra GH, Barreto-Grimaldos A, Simbaña-Rivera K, et al. Attitudes and perceptions of medical doctors towards the local health system: a questionnaire survey in Ecuador. BMC Health Serv Res. 2019 Jun 7;19(1):363. doi: 10.1186/s12913-019-4211-1.
Rotenstein LS, Huckman RS, Wagle NW. Making patients and doctors happier—the potential of patient-reported outcomes. N Engl J Med. 2017; 377:1309–12. doi: 10.1056/NEJMp1707537.
Harvey M, Al Shaar M, Cave G, Wallace M, Brydon P. Correlation of physician seniority with increased emergency department efficiency during a resident doctors’ strike. N Z Med J Online. 2008;121:59–68.
Poulton EC, Hunt GM, Carpenter A, Edwards RS. The performance of junior hospital doctors following reduced sleep and long hours of work. Ergonomics. 1978;21(4):279–95. doi: 10.1080/00140137808931725.
Subash F, Dunn F, McNicholl B, Marlow J. Team triage improves emergency department efficiency. Emerg Med J. 2004;21(5):542–4. doi: 10.1136/emj.2002.003665.
Donabedian A. Quality assessment and assurance: unity of purpose, diversity of means. Inquiry. 1988;173-192.
Mosadeghrad AM. Factors affecting medical service quality. Iran J Public Health. 2014 Feb;43(2):210-20.
Dimova A, Rohova M, Koeva S, Atanasova E, Koeva-Dimitrova L, Kostadinova T, et al. Bulgaria: health system review. Health Syst Transit. 2018;20(4):1-230.
Eurofound. European quality of life survey 2016: quality of life, quality of public services, and quality of society. Luxembourg: Publications Office of the European Union; 2017.
Akoglu H. User's guide to correlation coefficients. Turk J Emerg Med. 2018 Aug;18(3):91-93. doi:10.1016/j.tjem.2018.08.001.
Cohen J. Statistical power analysis for the behavioral sciences. Hillsdale (NJ): Lawrence Erlbaum Associates; 1988.
