Quality health care in Indian setup: an ear, nose, throat outpatient department-based approach for quality health care indicators


  • Himanshu Joshi Department of ENT, Military Hospital, Jabalpur, Madhya Pradesh http://orcid.org/0000-0003-2511-0428
  • Satyanjaya Sahoo Department of ENT, Military Hospital, Shillong, Meghalaya, India
  • Vikas Kumar Department of ENT, Military Hospital, Deolali, Maharashtra, India




Quality health care, Indian, ENT


Background: In this era doctor patient relationship facing hard times, especially in Indian setup. It is immensely evident in form of increasing lawsuits and violence against doctors. This brings patient centred approach with patient satisfaction into picture and further leads to concepts of quality health care. There is raised attention on enhancing the quality of life through the quality council of India. Here is an attempt to look for any causal association with the help of some routine indicators which if modified can lead to better state of doctor patient relationship.

Methods: This study has taken patient satisfaction into consideration with the help of quality care parameters at ear, nose, throat (ENT), outpatient department in Indian setup. These indicators are based on parameters divided into hospital domain and doctor domain and each parameter is graded on 5-point Likert scale.

Results: Score under doctor domain are significantly high statistically. Examination and communication by doctor (domain) are the parameters which scored the most. Under hospital domain the highest preference by patients in terms of score was given to hygiene and sanitation of hospital.

Conclusions: Quality health care is multifactorial and parameters under hospital domain and doctor domain are interdependent to much extent. It has been concluded statistically that examination and communication by doctor derives a better sense of trust and doctor patient relationship significantly.

Author Biography

Himanshu Joshi, Department of ENT, Military Hospital, Jabalpur, Madhya Pradesh

Lt Col (Dr)Himanshu Joshi 

Graded specialist, (ENT)


Emerson LP, Job A, Abraham V. A model for provision of ENT health care service at primary and secondary hospital level in a developing country. Biomed Res Int. 2013;2013:562643.

Dong W, Erens B, Shaw A, McMunn A, Field J, Haskell WL et al. Scottish Health Statistics. Edinburgh, Scotland, SD: Information and Statistics Division, National Health Service in Scotland; 1998.

McCormick A, Fleming D, Charlton J. London: Office of National Statistics, HMSO; 1995. Morbidity Statistics from General Practice 4th National Study 1992-1993.

White KL, Williams TF, Greenberg BG. The ecology of medical care. N Engl J Med. 1961;265:885-92.

Hannay DR. London: Routledge & Kegan Paul; 1979. The Symptom Iceberg. A Study of Community Health.

Dunnell K, Cartwright A. Medicine Takers, Prescribers and Hoarders. London: Routlege & Kegan Paul; 1972.

Green LA, Fryer GE, Jr, Yawn BP, Lanier D, Dovey SM. The ecology of medical care revisited. N Engl J Med. 2001;344:2021-5.

Hannaford PC, Simpson JA, Bisset AF, Davis A, McKerrow W, Mills R, et al. The prevalence of ear, nose and throat problems in the community: Results from a national cross-sectional postal survey in Scotland. Fam Pract. 2005;22:227-33.

Rao M, Rao KD, Shiva Kumar AK, Chatterjee M, Sundararaman T. Human resources for health in India. The Lancet. 2011;377:587-98.

Health Management Information system of the Ministry of Health and Family Welfare, Government of India. Available at: https://www.nrhm-mis.nic.in/Pages/RHS2015.aspx?RootFolder=%2 FRURAL%20HEALTH%20STATISTICS%2F%28A%29RHS%20-%202015&FolderCTID=& View={C50BC181-07BB-4F78-BE6FFCE916B64253}. Accessed on 18/06//2018.

Kishve SP, Kumar N, Kishve PS, Syed MM, Kalakoti P. Ear nose and throat disorders in paediatric patients at a rural hospital in India. Acad Manag J. 2010;3:786-90.

Singh A, Kumar S. A survey of ear, nose and throat disorders in rural India. Indian J Otolaryngol Head Neck Surg. 2010;62:121-4.

Indian Public Health Standards for Sub-centres, Primary Health Centres, Community Health Centres, Government of India, Ministry of Health and Family Welfare. Available at: http://www.nhm.gov.in/ nhm/nrhm/guidelines/indian-public-health-standards.html. Accessed on 15/04/2020.

Government of India, Ministry of Health and Family Welfare. National Programme for Prevention and Control of Deafness. 2016. Available at: http://www.dghs.gov.in/content/1362_3_NationalProgrammePreventionControl.aspx. Accessed on 18/04/2020.

Srinivasan K, Prabhu GR. A study of the morbidity status of children in social welfare hostels in Tirupati town. Indian J Community Med. 2006;31:170-2.

Chernew ME, Mechanic RE, Landon BE, Safran DG. Private-payer innovation in Massachusetts: the “alternative quality contract”. Health Aff (Millwood). 2011;30:51-61.

National Committee for Quality Assurance. Desirable Attributes of HEDIS. Available at: http://perma.cc/S5VD-QLLX. Accessed on 15/04/2020.

Glasziou PP, Buchan H, Del Mar C, Doust J, Harris M, Knight R et al. When financial incentives do more good than harm: a checklist. Bmj. 2012;345:e5047.]

Romeo GR, Abrahamson MJ. The 2015 Standards for Diabetes Care: Maintaining a Patient-Centered Approach. Ann Intern Med. 2015;162(11):785-6.

Robinson E, Blumenthal D, McGinniss JM. Vital signs: core metrics for health and health care progress. Washington DC: National Academies Press. 2015.

Blumenthal D, McGinnis JM. Measuring Vital Signs: an IOM report on core metrics for health and health care progress. JAMA. 2015;313:1901-2.

Woolf SH, Aron LY. The US health disadvantage relative to other high-income countries: findings from a National Research Council/Institute of Medicine report. Jama. 2013;309:771-2.

Hershberger PJ, Bricker DA. Who determines physician effectiveness? JAMA. 2014;31;312:2613-4.

American Association of Medical Colleges. Guiding Principles for Public Reporting of Provider Performance. 2014. Available at: https://www. aamc.org/download/370236/data/guidingprinciplesforpublicreporting.pdf. Accessed on 15/04/2020.






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