The Medical Journal of Basrah University

Background: Patient satisfaction is defined as the total judgments made by the recipient of a healthcare as to whether -or not- their expectations have been met. It is an important measure of healthcare quality as it offers information on the provider’s success to meet the clients’ expectations.The Study Objectives: The study aimed at measuring patient's satisfaction in primary health centers of Basrah governorate with a comparison between primary health centers that follow family medicine strategy versus general primary health centers.Methodology: It's a cross sectional study involved patients attended primary health care centers in Basrah governorate during June 2016.Standard check lists and questionnaires from Iraqi Ministry of Health were used to measure five main indicators of patient satisfaction including: appearance, credibility, responsiveness, security and empathy with a four likert scale to measure the satisfaction of patient. A total sample included 456 patients. Results: The lowest Cronbach's coefficient alpha value was found by the study to be in the "general appearance" dimension which included the general infrastructural appearance of the health facility with appropriate waiting areas for the attendees, cleanliness and lighting of the facility in addition to the general look and appearance of the health workers and service providers. While “assurance” dimensions shows the highest percentage of satisfaction. In addition, no significant difference was revealed for the chosen satisfactory dimensions between the health care centers providing family-medicine services compared to those with no family-medicine ones.Conclusions: The study remarks important weaknesses in some of the patient satisfactory dimensions including general appearance, responsiveness, apathy and assurance. However, it provides an evidence of having no significant difference for the chosen satisfactory dimensions between the health care centers providing family-medicine services compared to those with no family-medicine ones.

Introduction and Background: In Iraq, and due to the decades of wars and sunctions that affected people’s accessibility to the health care services, maternal death was among the main health problems over the years. Thus, studying the factors influencing this important problem is a mandatory step for a better evidence based intervention in controlling the problem. Objective: To analyze the socio-demographic factors that influence maternal deaths in Basrah during the period 2013-2017.Methodology design: The study is an observational retrospective one included information collected from the medical records, death certificate and forensic medicine reports in addition to interviewing the family as needed. A total of 201 deaths were included in the study. Results: The study shows that maternal death rate in Basrah increased sharply during 2016 compared to that of 2013 with a highest rate in Shat Al-Arab and Al-Mudiana districts. Then, a sharp decrease was noticed in 2017 compared to 2016. Maternal mortality rates were found to be increasing with increasing women’s age with the highest rate among women above 40 years old. But no big difference between maternal death rates in urban and rural areas. (88.1%) of the study women died in hospital while 11.9% of them died outside the hospital Conclusions and recommendations: Maternal death is still a problem in Basrah in spite of the decline that occurred between (2016-2017) compared to the rates in 2013. Strengthening of maternal mortality monitoring system across all districts of Basrah governorate in addition to improving the quality of registering all pregnancy related information are the main recommendations of the study.

Background: Medical records documentation is an important legal and professional requirement for all health professionals. They include information which describes all aspects of patient's care. But, despite the importance of medical records to support better quality service provided at the health facilities, incomplete documentation is very common all over the world.
Objective of the study: to assess the documentation completeness level of the medical records in the different inpatient wards of Basrah General Hospital.
Methodology: The study was a descriptive cross-sectional one. Medical records of 268 inpatients from Basrah General Hospital during June 2016 were included from four departments of the hospital (medicine, surgery, pediatrics and obstetrics and gynecology). A standard Iraqi Ministry of Health inpatient medical record with a two-level scoring system for assessing the level of documentation completeness were used in the study.
Results: the overall documentation level for the medical records included in the study was generally poor in 78% of the records. Surgical department was found to be the worse in documenting patient's notes related to medical history, while Gynecology and Obstetrics department was found to be the worst in documenting the medical examination assessment and the physician's notes related to the patient's state and details of any improvement / deterioration of his/her condition.
Conclusions and recommendations: The present study confirmed obvious incompleteness of documenting medical data for inpatient records in Basrah General Hospital especially in the general surgery, internal medicine and Gynecology and Obstetrics words. This is specifically found for the Physician notes (patient’s state and details of any improvement/deterioration of the condition) and the Clinical pharmaceutical sheet. A hospital based quality improvement project to improve the medical record documentation completion is highly recommended to be implemented by the Quality Assurance Unit of Basrah Directorate of Health.
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