Dissatisfaction between medical providers and patients in the Republic of Kazakhstan.

Background: Dissatisfaction among patients towards health care providers remains a serious concern in the Republic of Kazakhstan that requires further attention(1-3). Patient-centred care, trust between patients and medical providers, the involvement of patients in their own treatment process, and effective communication are major areas in need of strengthening in order to improve outcomes of medical care (4-7). The objective of this study was to broaden the investigation of patient dissatisfaction to various departments from different medical facilities in the city of Nur-Sultan and examine additional factors that may be influencing provider-patient communication and contributing to patient dissatisfaction. Methods: This cross-sectional study of 500 patients (response rate, 85.4%) and 500 health care providers (response rate, 86.4%) from one private and one state hospital and two state policlinics (outpatient departments) in the city of Nur-Sultan, Kazakhstan, used questionnaires containing the Patient-Practitioner Orientation Scale (PPOS) and scales assessing life and job satisfaction, job effort-job reward balance, and patient evaluation of communication. Results: Our study showed that the majority of health care providers and patients were doctor-centred as opposed to patient-centred in their expectations of the doctor visit. The patient-centred orientation of health care providers was negatively correlated with age (P=0.000218) and life satisfaction (P=0.000001). In patients, contrarily, patient-centredness was enhanced by higher life satisfaction (P=0.040), although negatively correlated with age (P=2.659E-21). Conclusions: The results of this study demonstrate that younger health care providers and those with lower life satisfaction expect a more patient-centred approach to the doctor visit. Older respondents and those with higher life satisfaction, in contrast, reported doctor-centred attitudes. The majority of younger patients have a stronger belief in good health associated with patient-centred care whereas the older population preferred a more doctor-centred approach to care. In all patients, the preference for patient-centred care was associated with higher satisfaction in life.