# Perceptions of healthcare quality indicators by anesthesiologists in intensive care departments in Ukraine

## TL;DR

This study explores how anesthesiologists in Ukraine perceive healthcare quality indicators, aiming to improve quality assessment systems in similar healthcare environments.

## Contribution

The study provides new insights into how anesthesiologists in specialized care perceive healthcare quality indicators compared to general practitioners.

## Key findings

- Anesthesiologists prioritize clinical indicators like prevention of thromboembolism and ventilator-associated pneumonia.
- Non-clinical indicators such as nurse-to-patient ratio and compliance with clinical guidelines are also highly valued.
- A significant relationship was found between patient relatives' satisfaction and the hospital owner type.

## Abstract

During the last decade more and more countries plan to reach universal healthcare coverage by 2030. Financial healthcare reform in Ukraine started in 2016, focusing on effective financing and providing access to qualitative medical services to the population. Primary healthcare started to change in 2018 followed by secondary and tertiary care in 2020. In 2022–2023 great challenges emerged because of the full-scale war. The aim of this research is to describe the perception of healthcare quality indicators among anesthesiologists in intensive care units in Ukraine, that might be used to improve the quality assessment system in Ukraine as well as in other countries that have similar healthcare systems or undergo similar processes of changing their specialized care.

Data were collected in November 2024 - January 2025 applying the survey as the main data collection method. The normality of the distribution of respondents’ age and work experience was assessed by the Kolmogorov-Smirnov test followed by the Mann-Whitney U test. Responses to the open-ended questions were initially categorized according to the established framework and subsequently analyzed using descriptive statistics and binary logistic regression analysis.

In total, 114 filled in questionnaires were received and included in the analysis. Doctors-anesthesiologists tend to perceive quality as a process quality. Among the most important clinical quality indicators for anesthesiologists there are “prevention of thromboembolism” (99.1%), “prevention of ulcer formation” (98.3%), “control of ventilator-associated pneumonia” (98.3%). Non-clinical indicators included “nurse-to-patient ratio” (100%), “availability of a mechanical ventilation weaning protocol” (100%) and “compliance to clinical guidelines” (96.5%). A statistically significant relationship (p˂0.05) between the indicator “Satisfaction of the patient’s relatives with the patient’s stay in the intensive care unit” and the independent variable “owner” was found.

Our research provides new insights into perception of healthcare quality and importance of quality indicators for its assessment among the medical doctors of specialized care. In comparison with the general practitioners focusing on the process quality, the focus of doctors-anesthesiologists lies in the outcome quality. But little consensus about healthcare quality remains to be an issue, as does the necessity to develop and promote a national quality policy and a national quality strategy.

The online version contains supplementary material available at 10.1186/s12913-025-13922-z.