Paper Title
HEALTHCARE QUALITY FROM THE PERSPECTIVE OF PATIENTS INGULF COOPERATION COUNCIL COUNTRIES: A SYSTEMATIC LITERATURE REVIEW

Abstract
Abstract Background With the increased focus on patient-centredcare, an increased need emerges for consensus on healthcare outcomes of importance to patients. The current study provides evidence based on a systematic review of the literature on the perspectives of patients on health care quality in Gulf Cooperation Councilcountries. Methods This study employeda qualitative systematic literature review design based on the guideline of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Online databases were searched for relevant peer-reviewed articles that were published since 2012 and that reported studies conducted in the Gulf Cooperation Councilregion and investigated healthcare quality from thepatient perspective. The study assessed articlesthat met the inclusion criteria for quality using standardised appraisal tools and analysed them using the qualitative content analysis method. Results The search retrieved 904 publications out of which28 were included in the final analysis. The majority of articles(83%) reported studies conducted in Saudi Arabia. Patients in Gulf Cooperation Councilcountries identified provider–patient communication problems, missed appointments with physicians, problems in emergency care access due to geographical distance and transportation barriers, long waiting times and physical environmentsas the most important aspects of healthcare quality. Otherpatients identified the knowledge and skills of healthcare providers as the majordeterminants of satisfaction with care. Several studies associated barriers to emergency care access with poor patient outcomes, including longer symptom duration, hospitalisation and high mortality. Conclusion Patients in Gulf Cooperation Councilcountries identified provider–patient communication, waiting time, emergency care access, the physical environment and provider competence as dimensions of quality that aremost important to them. Healthcare providers and policymakers in Gulf Cooperation Council countries can use the resultsto plan, assess and improve care delivery. Theyshould also ensure effective patient communication givenindividual differences, educational needs, cultures andlanguages. Keywords - Quality of care, Safety, Effect, Equity, Time, Patient-Centred