Patients’ Accessibility and Availability of Healthcare Services in a Level 1 Government District Hospital in Cabagan, Isabela: Basis for Quality Improvement Plan

Abstract

This study examined patients’ accessibility to and availability of healthcare services at Milagros Albano District Hospital, a Level 1 government district hospital in Cabagan, Isabela, as basis for a quality improvement plan. Anchored on Andersen’s Behavioral Model of Health Service Utilization and Donabedian’s Healthcare Quality Framework, the study assessed geographic accessibility, transportation, affordability, service availability, service delays, and patient satisfaction. A quantitative descriptive-correlational design was used. Data were gathered from 200 patients and selected healthcare providers through a structured questionnaire and were analyzed using frequency, percentage, chi-square test, and correlation-based interpretation. Findings revealed that most respondents came from low-income households, with 76% earning below ₱10,000 per month. A considerable proportion experienced access barriers: 41% traveled for more than one hour to reach the hospital, 75.5% relied on public transportation, and 61.5% reported difficulty accessing healthcare services. Transportation problems, bad weather or flooding, and damaged or under-construction bridges were the most common access barriers. In terms of service availability, 62% experienced delays in receiving medical attention, mainly due to long waiting time (59.7%), lack of doctors or nurses (27.4%), and limited medical supplies or equipment (12.9%). Despite these constraints, patient satisfaction was generally positive, with most respondents rating services as satisfactory or very satisfactory. The chi-square result showed a significant relationship between accessibility and availability (χ² = 10.11, df = 2, p = 0.006), indicating that patient-level access barriers were closely connected with system-level service constraints. Based on the findings, a quality improvement plan was proposed focusing on transportation support, improved patient flow and triage, workforce strengthening, resource upgrading, telemedicine, and stronger government support. The study contributes evidence for improving rural hospital service delivery through integrated, patient-centered, and multi-sectoral strategies.