Patient satisfaction survey with health care services is a growing concept in Nigeria where study on the subject is just beginning to gather momentum. Satisfaction with health care services has not been given the attention it deserves, let alone comparing institutional differences on the subject. The purpose of this study was to understand the factors that may account for differentials in patient satisfaction with radiological services in a public and a private hospital. A cross-sectional descriptive study was carried out in two hospitals of public and private nature in Enugu metropolis, Southeast Nigeria. Three hundred respondents responded to the survey; one hundred and forty five from the public hospital and one hundred and fifty five from the private hospital. Males were ninety two 92(30.7%) in number while females constituted the majority with two hundred and eight 208(69%). The data was analyzed in terms of descriptive statistics using 95% confidence interval. ANOVA test for significance, chi-square for association and regression for differences were applied in the analysis. Patient satisfaction with radiological services was better and in favour of the private hospital which registered a mean level of satisfaction of 3.96 as against the public hospital that registered a mean level of satisfaction of 3.43, at 95% confidence interval. Respondents at both facilities were not impressed by radiographers/nurses in nine same service areas and as such performances in those areas were poorly rated and were seen as sources of dissatisfaction. Providers of health care services and radiographers in particular need special orientation in customer relations to foster good patient satisfaction strategies. Governments and the university system could help in this direction by improving on the curricula of radiographers to include professional code of conduct and patient-centredness while in the university.

Background: Dual Practice (DP) allows full-time public sector doctors to concurrently offer the same clinical services in the private sector. The debate against this practice seems to be largely influenced by its potential to reduce the contracted hours in the public sector and shift attention to private work. Purpose: The purpose of this secondary research is to estimate the monetary value of hours lost to the Nigerian public healthcare system when full-time government employee doctors are engaged in private practice. It attempts to quantify the amount of resource outflow from the public system due to absences and lateness arising from competition for time between the public system's contracted hours and private practice. Methods: Sensitivity analysis in Excel 2010 was used to calculate doctors' hourly pay in the public sector using the 2015 Consolidated Medical Salary Structure for medical and dental officers in Nigeria's federal public service. The parameters used for the calculation were the official 40-hour working week and the average monthly gross pay of doctors on different grade levels. Hypothetical scenarios of hours lost due to absences associated with DP were created. The value of different hypothetical hour losses by the percentage of doctors assumed to engage in dual practice across all doctor grade levels was then computed. Results: The estimated annual value of hours lost from dual practice to a single public tertiary care hospital was N4,851,754 or 15,855 USD (best case scenario) and N19,407,017 or 63,422 USD (worst case scenario) for the normal routine work and N1,800,133 or 5883 USD (best case scenario) and N3,600,266 or 11,766 USD (worst case scenario) for the on-call duty. Conclusion: The government may have been How to cite this paper: Eze, B.S., Jones, M. and Kyaruzi, I.S.

Dual practice (DP) occurs when doctors employed in the public sector work concurrently in private practice. This study examines the perceived effects of DP on the public healthcare system in Enugu Urban area, Nigeria and the burden on patient finances. The study comprises a survey of 407 service users who had visited both public and private health facilities in the last year, focus groups exploring service users' perceptions of benefits and disbenefits, interviews with DP and non-DP doctors exploring why they engaged in DP or refrained from doing so, and interviews with policy makers and senior administrators on their views of DP. Additionally, sensitivity analysis was used to calculate doctors' hourly pay in the public sector and to create hypothetical estimates of the value of hours lost due to absences associated with DP. The estimated annual value of hours lost from DP to a single public tertiary care hospital was US$16,013 (best case scenario) and US$63,399 (worst case scenario). Benefits of DP were identified as speedier attention, reduced bureaucracy in private practice and reduction of pressure in public hospitals among others. Reported disbenefits included low commitment to public patients, late reporting and absence of doctors from work, and sharp practices. The public system was ranked higher in respect of the structure element of healthcare quality, whereas private practice performed better in the process and outcome elements of quality. The main motives for DP were seen as income enhancement followed by prestige and fringe benefits enjoyed in the public system. Reasons given by non-DPs for working exclusively in the public sector included the stress of private practice, family issues and career development. Among the different mechanisms and options proposed for managing the issue of DP in Nigeria, intramural practice appeared to command most support from policy makers and other senior stakeholders.

Introduction: In Nigeria radiographers practice in both public and private hospitals, yet there are lingering differences in perceptions among patients about the professional conduct of radiographers related to the type of hospital they work in. The purpose of this study was to investigate these differences and make policy recommendations. Methods: A cross-sectional study was undertaken in which 300 respondents (patients) who had received outpatient radiological services in a public and a private hospital answered a questionnaire. Results: The results showed that radiographers in the public facility excelled in five professional areas, including the principle of informed consent and the right of patients or their carers to refuse service or treatment, while radiographers in the private facility performed better in ten professional areas, including the observation of appropriate professional boundaries. Conclusion: Lack of enforcement of professional rules and regulations regarding the conduct of radiographers is a major problem. A monitoring body overseeing the professional conduct of radiographers is highly recommended to improve public trust and confidence in radiological services in public and private hospitals.

Objective: Although the differences in the quality levels between the public and private sectors have been identified in literature not much is known about the level of quality differences that exist when full time government employee doctors offer the same clinical services in their own privately managed facilities. The objective of this study was to compare service user perceived quality of care provided by full-time government employee doctors in the public system and in their own privately managed facilities in Nigeria.Methods: A cross-sectional multistage sampling design was used to elicit service user views on process, structure and outcome elements of quality identified in the Donabedian’s care quality model. The software for population surveys in EPI Info 7 was used to calculate the required sample. A total of 407 questionnaires were administered and completed after a pre-test.Results: Respondents reported better health outcomes in private practice than in the public system and a majority would recommend visiting a dual physician’s private practice than the public system where they work full-time. Process aspects of quality, including better rapport with doctors, greater perceived confidentiality, shorter wait times, and absence of bureaucratic impediments were said to be better in privately managed facilities of government doctors. However, respondents said that the public sector was superior in respect of the structure element of quality as reflected in better infrastructure, equipment, and availability of drugs.Conclusions: Despite the relatively lower cost of care in government hospitals the outcome and process elements are still crucial in determining which sector patients prefer. These two elements seem to have influenced patronage for private practices of dual practitioners.