Integrated logo Integrated Health Care Limited
Health Maintenance Organization
Current date time: 10/19/2017 10:53:40 PM
INTEGRATED HEALTH CARE PROVIDER HOSPITAL SURVEY

Dear Valued Enrollee,
Kindly spare a moment to respond to this survey on the quality of service provided by the health care facility you just visited.


NAME OF THE HOSPITAL/HEALTH CARE FACILITY: *
DATE OF ATTENDANCE: *
:
 

PART A

1. Were you denied care on the grounds that you are an NHIS enrollee?

   If 'YES', please state the reason given:
   

2.Were you asked to pay for services covered by the scheme ?

   If 'YES', please state the services.
   

3.Did you get your approval promptly on referral to secondary care?

   If 'NO', please state the reason given:
   

4. Did you make 10% Co-payment for:
a.) Prescribed drugs Only? b.) Other services rendered?
5.Were you well managed?

   Please provide details(Optional):
   

PART B

1. Kindly rate the quality of your reception at the facility.




   Please, provide details (optional)
   

2. Kindly rate the level of hygiene at the facility.




   Please, provide details (optional)
   

3. Kindly rate the quality of doctors' consultation at the facility.




   Please, provide details (optional)
   

4. Kindly rate the availability of drugs at the facility pharmacy




   Please, provide details (optional)
   

5. Kindly rate how best managed was the waiting time before seeing a doctor.




   Please, provide details (optional)
   

6. kindly rate how best managed was the waiting time before getting the investigation done.




   Please, provide details (optional)
   

7. Kindly rate how best managed was the waiting time before receiving drugs.




   Please, provide details (optional)
   

8. Kindly rate the suitability of the attitude of the following staff of the facility.
a.) DOCTORS : b.) NURSES : c.) RECEPTION : d.) PHARMACISTS : e.) LABORATORY SCIENTISTS : f.) RADIOGRAPHY UNIT : g.) HOSPITAL SECURITY : h.) HOSPITAL CLEANERS :
8. Would you recommend this facility to another enrollee?