Why are people dissatisfied with medical care services in Lithuania? A qualitative study using responses to open-ended questions

OBJECTIVES: To identify and describe the main sources of dissatisfaction with medical services among the population in Lithuania. DESIGN: Analysis of written responses to an open-ended question as a part of a questionnaire survey. PARTICIPANTS: A randomly selected group of 25--64-year-old men and women from the Utena and the Kaisiadorys regions of Lithuania. Of the 1395 survey respondents, 357 persons (25.6%) answered the question regarding the dissatisfaction with health care services. MAIN OUTCOME MEASURES: Identification of the sources of dissatisfaction with medical care services among study participants. RESULTS: Twelve categories of dissatisfaction were identified that were related to three levels: shortcomings in the health care system (systemic level), deficiencies in provision and quality of services (institutional level) and deficiencies in physicians' attitudes, skills and work (individual level). CONCLUSION: Consumers' perceptions of medical care quality can be analysed by using information obtained from simple survey material and can be used to improve the quality of service. The causes of dissatisfaction with medical service can be traced to the development of the health care delivery system and patients' rights in a country.