Satisfaction of Health Care Users with the Quality of Health Care Services in Senegal: A Multi-Level Approach

Abstract

This paper analyzes the satisfaction of health care users with the quality of health care in the different types of health facilities in Senegal. The data used come from a survey of the Senegalese health system. In this framework, the multi-level approach with three levels of aggregation was used: patients (level 1), health facilities (level 2) and 14 administrative regions (level 3). The estimation results indicate a diversity, on the one hand, between regions, and on the other hand between health facilities. In addition, the individual characteristics of the patients have diverse effects across the levels of aggregation: the significance of most of them differs with respect to the context (e.g., gender, education level, age, smoking status and ownership of health insurance). While the waiting time and the applied rate effects differ slightly in terms of significance, the former influences negatively the satisfaction when waiting time is less than the duration of an appointment of the following day, whereas the level of satisfaction increases with the rate applied on health care.