Ghana’s healthcare system is defined by the coexistence of public and private institutions, offering patients options for accessing health services.

Despite improvements in health infrastructure and services over the years, citizens still face decisions on whether to choose public or private healthcare providers.

This preference is shaped by several factors, including service quality, satisfaction, and the nature of the ailment being treated.

A recent study by a master’s graduate of the Kwame Nkrumah University of Science and Technology, Eric Amponsah, was conducted across Kumasi Metropolis in the Ashanti Region and Sefwi-Bibiani in the Western Region.

It sought to understand the factors influencing Ghanaians' preferences between public and private healthcare facilities. He surveyed 600 residents who were 18 years and above.

The findings of the research showed the healthcare choices of Ghanaians and their impact on health delivery.

Findings

The research revealed that the choice between public and private healthcare was influenced by service quality, word-of-mouth recommendations, and the type of ailment being treated.
According to the data, respondents were more likely to choose public hospitals for specific types of services, particularly when the illness required specialized care that they believed public facilities could provide better.

"Public hospitals are more equipped when it comes to managing certain illnesses, especially those that require specialist services. However, patients complain about the long waiting times in public hospitals," said a healthcare professional at one of the public hospitals in Kumasi.

On the other hand, private hospitals were preferred for the perceived efficiency and comfort they provided, particularly for routine or less complex treatments.
The study revealed that private hospitals outperformed public ones in several areas, including medical services, nursing services, support services, administrative services, patient safety, and hospital infrastructure.

One patient from Sefwi-Bibiani shared her experience.

"I prefer private hospitals because I am attended to quickly. I don’t have to wait long, and the environment is more comfortable."

Despite these positive impressions of private healthcare, public hospitals were found to perform better in one area which is patient communication.
This refers to the clarity and frequency of communication between healthcare providers and patients during treatment.

The research indicated that patients who visited public hospitals felt better informed about their conditions and the treatment processes than those who attended private facilities.
"One thing that public hospitals do well is taking time to explain the treatment process to you. The doctors are more open to answering questions," said another participant from Kumasi.

Satisfaction levels

Satisfaction levels between public and private hospitals showed a slight favour for private institutions. Individuals who patronized private hospitals reported higher levels of satisfaction with the services they received.

However, the study found that this satisfaction was primarily linked to factors such as shorter waiting times and better hospital infrastructure rather than the actual medical care provided.

For public hospitals, the satisfaction levels were lower, especially regarding long waiting times. Patients expressed frustration at the extended durations spent in queues before receiving treatment.

"It can take a whole day just to see a doctor in a public hospital. The system needs to be improved," said a frustrated patient.

Despite the lower satisfaction ratings for public hospitals, many patients acknowledged that these institutions were often better equipped to handle severe health conditions due to their larger size and broader range of medical expertise.

Private hospitals, while preferred for their comfort and speed, were often viewed as more suitable for non-emergency situations or less complicated ailments.

Service quality and patient safety

The study revealed that service quality was a significant determinant of patients' choices between public and private healthcare. Private hospitals scored higher in terms of service delivery, particularly in areas such as nursing and administrative services.

Patients described the nursing care in private hospitals as more attentive, and the administrative processes as more efficient. One participant said, "In private hospitals, the nurses are more responsive, and the processes are smoother. You don't feel lost in the system." Patient safety was another area where private hospitals performed well.

These facilities tend to have stricter safety protocols in place, particularly when it comes to infection control and the general cleanliness of the environment.

Private hospitals' ability to maintain high standards in these areas contributed to their perceived higher quality of care.

Public hospitals, though generally seen as safer due to their size and capacity, often suffer from overcrowding, which can pose challenges to maintaining the same level of patient safety.

Recommendations for improvement

The study pointed out several areas for improvement in both public and private healthcare sectors.

For public hospitals, the most pressing issue is the long waiting times that patients experience. One potential solution suggested is the creation of additional consulting units, which could help to reduce congestion and speed up the treatment process.

"Improving the waiting time in public hospitals should be a priority. Adding more consulting units and adopting an appointment-based system for non-emergency services could alleviate some of the pressure," Ebenezer Agyapong healthcare administrator recommended.

For private hospitals, Ebenezer suggested that importance be placed on patient communication and counselling.

By improving the information flow between doctors and patients, private hospitals could provide a service that goes beyond treatment and focuses on ensuring that patients fully understand their health conditions and treatment options.

In the words of Louisa Nina Frimpong, a healthcare professional from Kumasi, "Both public and private hospitals have their strengths. What matters is how we can leverage these strengths to improve healthcare delivery across the board."