Public opinion about the health care system in Armenia: findings from a cross-sectional telephone survey
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(2020) 20:1005
RESEARCH ARTICLE
Open Access
Public opinion about the health care system in Armenia: findings from a crosssectional telephone survey Tsovinar Harutyunyan1 and Varduhi Hayrumyan2*
Abstract Background: Few studies have examined public opinion about the health care system in the former Soviet region. The objective of our study was to evaluate the population’s satisfaction with the health care system and identify factors associated with it in Armenia. Methods: We conducted a cross-sectional telephone survey among 576 adult residents of the capital Yerevan using Random Digit Dialing technique. Simple and multivariate logistic regression explored associations between potential determinants and satisfaction. Results: A substantial proportion of respondents (45.5%) were dissatisfied or very dissatisfied with the health system. About 49% of respondents negatively evaluated the ability of the system to provide equal access to care. About 69% of respondents thought that the responsibility for an individual’s health should be equally shared between the individual and the government or that the government’s share should be larger. The adjusted odds of satisfaction were higher among individuals with better health status, those who positively rated equal access and respect to patients in the system, those thinking that the responsibility for health should be equally shared between the individual and the government, and those who tended to trust the government. Conclusions: This study enriched our understanding of factors that shape the population’s satisfaction with the health care system in different cultural and political environments. We recommend further exploration of public opinion about those system attributes that are not directly linked to patient experiences with care, but might be equally important for explaining the phenomenon of satisfaction.
Background The importance of assessing patient satisfaction as an essential component of health care outcomes has been long recognized [1]. While most of the studies in this field focus exclusively on patients’ experiences with health care services, the research that explores population’s satisfaction with health care system, in general, is relatively limited [2, 3]. The literature addressing both * Correspondence: [email protected] 2 Varduhi Hayrumyan, Turpanjian School of Public Health, American University of Armenia, 40 Marshal Baghramyan Ave., 0019 Yerevan, Armenia Full list of author information is available at the end of the article
patient and general population satisfaction in the former Soviet Union countries is particularly scarce [3, 4]. In Armenia, as well as in many other former Soviet countries, the health care system destabilized following independence in 1991, leading to a substantial decline in access to and quality of health care [4–6]. The governments in the post-Soviet region faced an increasing gap between their commitments to free health care and fiscal constraints [3]. The countries have substantially varied in terms of trajectories of
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