Dissertation Abstracts

The Study of Social Factors of Health Care Quality and Access (Analysis of Medical Sociology)

Author: Sengedorj, Munkhbaatar , smunkhbaatar@gmail.com
Department: Sociology and Social wok
University: National University of Mongolia, Mongolia
Supervisor: MUNKHBAT Orolmaa
Year of completion: 2013
Language of dissertation: Mongolian

Keywords: Medical Sociology , Sociology of Health , Social factors of He , Sociology and Health
Areas of Research: Health , Social Classes and Social Movements , Poverty, Social Welfare and Social Policy


The main goal of the study is to determine the present condition of quality and accessibility of health care service in Mongolia through the social factors of health, to explore the ways that improve the accessibility within implementation of system changes, and to propose a recommendation.
Epidemiological changes in the types of illnesses and diseases in the Mongolian population have been occurring since 1990, and diseases caused by behavioral or social factors such as cardiovascular diseases, various cancers, diabetes, as well as diseases related to injuries and traumas are becoming prevalent. More and more, these diseases are the leading causes of death.
62.4% of respondents evaluated their satisfaction for health service as lower than average while 7.7% as very low and 30% as higher than average. Most importantly, the overall satisfaction of respondents was extremely low and only 1/3% were satisfied with their received health service and gave a positive evaluation. In total, the clients from primary health care and rural regions had much lower satisfaction. The satisfaction level of citizens increased as their social classes and education levels become higher. Thus there was a directly proportional relationship between these two variables.
With regard to the evaluation for physicians’ communication skill and attitude, the family health centers of primary level received the lowest score (primary level 2,39±0,57, second level 2,53± 0,55, third level 2,49±0,56, p-0.016.)
Even though the satisfaction was not high for both urban and rural respondents, in general rural respondents’ satisfaction level was relatively lower and this score was 2.9 and 2.3 for urban and rural region respectively (statistical significance 0.044.)
Given the social classes of respondents in this study, the satisfaction levels of the middle class was 70%, the lower class 22%, and the representatives of the upper class 8%. As for variation in satisfaction levels across class, the middle class attached more positive value to the health service than the upper and lower classes. For the lower class, the satisfaction score was the lowest. 36% of middle class respondents considered the health service as higher than average while this indication was 23.8% for the lower class and 27.5% for the upper class. Within the group of respondents who underlined the low, 7% of respondents from the lower class were dissatisfied with the service and chose the very low. Of the group, 4.4% were from the middle class and 2% were from the upper class respondents.
It is important to regard access as an instrument for improving health condition and satisfaction. For instance, the conceptions that planned care and service should be identical in every local community in order to promote “justice” and reach the expected level of health condition and satisfaction, has been dominated. On the other hand, if the efficient service is counted as valuable, the inefficient service is counted as not valuable. It is obvious that accessibility of health service is poor when the outcomes are insufficient.