Assessment of quality of care and patient satisfaction in public and private hospitals in Lubumbashi, Democratic Republic of the Congo

Abstract

Introduction: In the Democratic Republic of Congo, the healthcare system faces the major challenge of providing quality healthcare for its steadily growing population. The study assesses the quality of healthcare in the city of Lubumbashi, determines the rate of overall patient satisfaction, the availability and usability of medical equipment, and equipment shortages. It also analyses the factors associated with overall satisfaction. Methods: A cross-sectional, observational, descriptive study coupled with a quality-of-care assessment was conducted. A three-stage cluster random sampling of 1396 patients was used. For medical equipment management indicators, 18 respondents were managers or resource persons from selected centroid health facilities. Face-to-face interviews were conducted from January 25, 2025, to April 25, 2025. Data were processed using Excel 2013, SPSS v.26, and R-4.5.2-win software. Results: The study revealed that 54.4% of patients were overall satisfied, with a significant difference between the public and private sectors (p = 0.020). Satisfaction rates were significantly higher for private centroid health facilities than for public ones (p<0.001). The private sector shows a high medical equipment Availability Rate (AR) of approximately 85% compared to a critical level of nearly 30% in the public sector (p<0.0001). Factors associated with overall satisfaction include: Status (aPR = 0.82; 95% CI: [0.68 - 0.99]; p = 0.040); In-hospital hygiene (aPR = 0.82; 95% CI: [0.69 - 0.97]; p = 0.020) and Respect for privacy/precautions taken (aPR = 1.40; 95% CI: [1.20 - 1.65]; p<0.001). Conclusion: The city of Lubumbashi shows a low overall satisfaction rate. Private health facilities achieved very high satisfaction scores, reflecting their investment in quality of care to meet patient demands.