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Sato K, Baba M, Morita T, Masukawa K, Shima Y, Tsuneto S, Kizawa Y, Miyashita M. Continuous Electrocardiographic Monitoring for 24 Hours Before Death in Patients with Terminal Cancer. Am J Hosp Palliat Care 2024; 41:1145-1156. [PMID: 38091554 DOI: 10.1177/10499091231222184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2024] Open
Abstract
BACKGROUND Purposeless physiological monitoring at the end-of-life is not recommended. However, studies on how families feel regarding the death of patients with terminal cancer without continuous electrocardiographic monitoring (CEM) are lacking. OBJECTIVES To explore the impact on the quality of care and the feelings and psychological distress experienced by families when CEM is not used during the 24 hours preceding a patient's death. METHODS In this multicenter cross-sectional, self-report questionnaires were distributed to 1087 bereaved families at Japanese specialized palliative care units in 2018. RESULTS Out of 671 responses, 394 valid responses were analyzed. Families of nonmonitored patients (NM-group) accounted for 79.2%, while those with bedside electrocardiogram monitoring (MB-group) and remote nurse station monitoring (MC-group) comprised 11.9% and 8.9%, respectively. In the NM-group, 85.5% expressed satisfaction without CEM, which was more than 10% lower than other groups. While 14% in the NM-group desired patient monitoring, families who received adequate explanations about CEM had lower proportions compared to the MB-group (P = .021). Univariate analyses showed no significant differences in evaluations of the quality of care and families' psychological distress (mean scores of Overall Care Satisfaction, Care Evaluation Scale, Good Death Inventory, Brief Grief Questionnaires) across all groups. CONCLUSION While the majority of NM-group were satisfied with their patient's care without CEM, the proportion of dissatisfied families was higher than in other groups. Although not using CEM is not a major hindrance to end-of-life care for patients with terminal cancer, providing sufficient explanations may be important for satisfactory care.
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Affiliation(s)
- Ko Sato
- Hospice, Ise Municipal General Hospital, Ise, Japan
| | - Mika Baba
- Department of Palliative Medicine, Suita Tokushukai Hospital, Suita, Japan
| | - Tatsuya Morita
- Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan
- Research Association for Community Health, Hamamatsu, Japan
| | - Kento Masukawa
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Yasuo Shima
- Department of Palliative Medicine, Tsukuba Medical Center Hospital, Tsukuba, Japan
| | - Satoru Tsuneto
- Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Yoshiyuki Kizawa
- Division of Clinical Medicine, University of Tsukuba Faculty of Medicine, Tsukuba, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, Japan
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Tian CY, Wong ELY, Qiu H, Zhao S, Wang K, Cheung AWL, Yeoh EK. Patient experience and satisfaction with shared decision-making: A cross-sectional study among outpatients. PATIENT EDUCATION AND COUNSELING 2024; 129:108410. [PMID: 39217830 DOI: 10.1016/j.pec.2024.108410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Revised: 08/09/2024] [Accepted: 08/24/2024] [Indexed: 09/04/2024]
Abstract
OBJECTIVES This study aimed to investigate how doctor-patient communication, trust in doctors impacted patients' experience and satisfaction in shared decision-making (SDM). METHODS This study is based on the data from a cross-sectional survey (n = 12,401) conducted in 27 public specialist outpatient clinics in Hong Kong. RESULTS The multivariable regression models revealed that doctors' better communication skills were associated with lower decision-making involvement (odd ratio, 0.75 [95 % CI, 0.88-0.94], P < .001) but higher satisfaction with involvement (odd ratio, 6.88 [95 % CI, 5.99-7.93], P < .001). Similarly, longer consultation durations were associated with reduced involvement in decision-making (odd ratio, 0.71 [95 % CI, 0.66-0.73], P < .001) but increased satisfaction with involvement (odd ratio, 1.91 [95 % CI, 1.80-2.04], P < .001). Trust in doctors significantly mediated these associations, except for the association between consultation duration and patients' satisfaction with decision-making involvement. CONCLUSION Doctors' better communication skills and longer consultations might not necessarily increase patient involvement in SDM but correlated with increased satisfaction with involvement. Trust in doctors emerged as a mediator for participation and satisfaction in decision-making. PRACTICE IMPLICATIONS Clinics should consider patients' preferences and capabilities when tailoring communication strategies about decision-making and optimizing patient satisfaction.
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Affiliation(s)
- Cindy Yue Tian
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eliza Lai-Yi Wong
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China.
| | - Hong Qiu
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Shi Zhao
- School of Public Health, Tianjin Medical University, Tianjin, China
| | - Kailu Wang
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Annie Wai-Ling Cheung
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
| | - Eng-Kiong Yeoh
- JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China; Centre for Health Systems and Policy Research, JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong SAR, China
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Bsteh G, Macher S, Krajnc N, Marik W, Michl M, Müller N, Zaic S, Harreiter J, Novak K, Wöber C, Pemp B. An interdisciplinary integrated specialized one-stop outpatient clinic for idiopathic intracranial hypertension - a comprehensive assessment of patient satisfaction. J Headache Pain 2024; 25:127. [PMID: 39090530 PMCID: PMC11295347 DOI: 10.1186/s10194-024-01835-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2024] [Accepted: 07/25/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND Management of idiopathic intracranial hypertension (IIH) is complex requiring contributions from multiple specialized disciplines. In practice, this creates considerable organizational and communicational challenges. To meet those challenges, we established an interdisciplinary integrated outpatient clinic for IIH with a central coordination and a one-stop concept. Here, we aimed to evaluate effects of this one-stop concept on subjective patient satisfaction and economic outcome in patients with IIH. METHODS In a retrospective cohort study, we compared the one-stop era with integrated care (IC, 1-JUL-2021 to 31-DEC-2022) to a reference group receiving standard care (SC, 1-JUL-2018 to 31-DEC-2019) regarding subjective patient satisfaction (assessed by the Vienna Patient Inventory). Multivariable binary linear regression models were used to adjust for confounders. RESULTS Baseline characteristics of the IC group (n = 85) and SC group (n = 81) were comparable (female: 90.6% vs. 90.1%; mean age: 33.6 vs. 32.8 years, educational level: ≥9 years of education 60.0% vs. 59.3%; located in Vienna 75.3% vs. 76.5%). Compared to SC, management within IC concept was associated with statistically significantly higher subjective patient satisfaction (beta = 0.93; p < 0.001) with the strongest effects observed in satisfaction with treatment accessibility and availability (beta = 2.05; p < 0.001). Subgroup analyses of patients with migration background and language barrier consistently indicated stronger effects of IC in these groups. CONCLUSIONS Interdisciplinary integrated management of IIH statistically significantly and clinically meaningfully improves patient satisfaction - particularly in socioeconomically underprivileged patient groups. Providing structured central coordination to facilitate and improve access to interdisciplinary management provides means to further improve outcome.
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Affiliation(s)
- Gabriel Bsteh
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Vienna, Austria.
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria.
| | - Stefan Macher
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Nik Krajnc
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Marik
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
- Department of Neuroradiology, Medical University of Vienna, Vienna, Austria
| | - Martin Michl
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
| | - Nina Müller
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Sina Zaic
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Jürgen Harreiter
- Division of Endocrinology, Department of Internal Medicine, Medical University of Vienna, Vienna, Austria
| | - Klaus Novak
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
- Department of Neurosurgery, Medical University of Vienna, Vienna, Austria
| | - Christian Wöber
- Department of Neurology, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Vienna, Austria
- Comprehensive Center for Clinical Neurosciences & Mental Health, Medical University of Vienna, Vienna, Austria
| | - Berthold Pemp
- Department of Ophthalmology, Medical University of Vienna, Vienna, Austria
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Yan J. An Analysis of Inpatient Satisfaction with Trust-related Factors of Public Secondary and Tertiary Hospitals in China. Qual Manag Health Care 2024; 33:166-175. [PMID: 38941583 DOI: 10.1097/qmh.0000000000000480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2024]
Abstract
BACKGROUND AND OBJECTIVES Patient satisfaction surveys are implemented as an essential quality improvement tool in healthcare markets. This study investigates patient satisfaction in public secondary and tertiary hospitals and identifies factors contributing to inpatient satisfaction, particularly trust-related factors, to eventually improve the quality of care in the healthcare system. METHODS A population-based cross-sectional survey was conducted between February and April 2021 in 31 Chinese provinces. Telephone interviews with computer assistance were used to gather data. Spearman Rank Correlation was used to analyze satisfaction with hospitalization services between secondary and tertiary hospitals. Multiple Linear Regression was used to determine the influencing factors of overall patient satisfaction. RESULTS Inpatients reported more satisfaction with inpatient care when doctors treated them respectfully (p < 0.01). Inpatients with higher self-identified social class reported higher satisfaction (p < 0.01). Inpatients who trust in most people in society (p < 0.01) and trust in the Chinese healthcare system (p < 0.01) reported higher satisfaction. Female inpatients reported higher overall satisfaction (p < 0.01). CONCLUSIONS The study of Chinese inpatients in secondary and tertiary hospitals highlighted the importance of respect from doctors, their self-identified social class, and their trust in influencing satisfaction during their hospital stay and called for additional research into policy measures.
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Affiliation(s)
- Jingjing Yan
- Author Affiliation: Department of Public Administration, College of Philosophy, Law & Political Science, Shanghai Normal University, Shanghai, China
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Mallick R, Solomon G, Bassett P, Zhang X, Patel P, Lepeshkina O. Subcutaneous immunoglobulin replacement therapy in patients with immunodeficiencies - impact of drug packaging and administration method on patient reported outcomes. BMC Immunol 2024; 25:18. [PMID: 38378441 PMCID: PMC10880328 DOI: 10.1186/s12865-024-00608-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 02/07/2024] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND Here, the perspective of patients with primary and secondary immunodeficiency receiving subcutaneous immunoglobulin (SCIg) via introductory smaller size pre-filled syringes (PFS) or vials were compared. METHODS An online survey was conducted in Canada by the Association des Patients Immunodéficients du Québec (APIQ) (10/2020-03/2021). Survey questions included: reasons for choosing SCIg packaging and administration methods, training experiences, infusion characteristics, and switching methods. The survey captured structured patient-reported outcomes: treatment satisfaction and its sub-domains, symptom state, general health perception, and physical and mental function. Respondents using PFS were compared with vial users, overall and stratified by their administration method (pump or manual push). RESULTS Of the 132 total respondents, 66 respondents used vials, with 38 using a pump and 28 using manual push. PFS (5 and 10 mL sizes) were being used by 120 respondents, with 38 using a pump and 82 using manual push. PFS users were associated with a 17% lower median (interquartile range) SCIg dose (10 [8, 12] vs. 12 [9, 16] g/week, respectively), a significantly shorter infusion preparation time (15 [10, 20] vs. 15 [10, 30] mins, respectively), and a trend for shorter length of infusion (60 [35, 90] vs. 70 [48, 90] mins, respectively) compared with those on vials. Patient-reported treatment satisfaction scores were overall similar between vial and PFS users (including on the domains of effectiveness and convenience), except for a higher score for vials over PFS on the domain of global satisfaction (p=0.02). CONCLUSIONS Consistent with prescribing that reflects a recognition of less wastage, PFS users were associated with a significantly lower SCIg dose compared with vial users. PFS users were also associated with shorter pre-infusion times, reflecting simpler administration mechanics compared with vial users. Higher global satisfaction with treatment among vial users compared with PFS users was consistent with users being limited to smaller PFS size options in Canada during the study period. Patient experience on PFS is expected to improve with the introduction of larger PFS sizes. Overall, treatment satisfaction for SCIg remains consistently high with the introduction of PFS packaging compared with vials.
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Affiliation(s)
- R Mallick
- CSL Behring, King of Prussia, PA, USA.
| | - G Solomon
- Association des Patients Immunodeficients du Québec, Québec, Canada
| | - P Bassett
- Meridian HealthComms Ltd, Manchester, UK
| | - X Zhang
- CSL Behring, King of Prussia, PA, USA
| | - P Patel
- Formerly of CSL Behring, King of Prussia, PA, USA
| | - O Lepeshkina
- Centre hospitalier de l'Université Laval, Québec, Canada
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Buclin CP, Uribe A, Daverio JE, Iseli A, Siebert JN, Haller G, Cullati S, Courvoisier DS. Validation of French versions of the 15-item picker patient experience questionnaire for adults, teenagers, and children inpatients. Front Public Health 2024; 12:1297769. [PMID: 38439757 PMCID: PMC10910618 DOI: 10.3389/fpubh.2024.1297769] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Accepted: 01/30/2024] [Indexed: 03/06/2024] Open
Abstract
Objectives No French validated concise scales are available for measuring the experience of inpatients in pediatrics. This study aims to adapt the adult PPE-15 to a pediatric population, and translating it in French, as well as to establish reference values for adults, teenagers, and parents of young children. Methods Cultural adaptation involved forward and backward translations, along with pretests in all three populations. Dimensional structure and internal consistency were assessed using principal component analysis, exploratory factor analysis, and Cronbach's alpha. Construct validity was assessed by examining established associations between patient satisfaction and inpatient variables, including length of stay, and preventable readmission. Results A total of 25,626 adults, 293 teenagers and 1,640 parents of young children completed the French questionnaires. Factor analysis supported a single dimension (Cronbach's alpha: adults: 0.85, teenagers: 0.82, parents: 0.80). Construct validity showed the expected pattern of association, with dissatisfaction correlating with patient- and stay-related factors, notably length of stay, and readmission. Conclusion The French versions of the PPE-15 for adults, teenagers and parents of pediatric patients stand as valid and reliable instruments for gauging patient satisfaction regarding their hospital stay after discharge.
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Affiliation(s)
- Clement P. Buclin
- Division of Quality of Care, University Hospitals of Geneva, Geneva, Switzerland
- Department of Medicine, University of Geneva, Geneva, Switzerland
| | - Adriana Uribe
- Division of Quality of Care, University Hospitals of Geneva, Geneva, Switzerland
| | - Justine E. Daverio
- Division of Quality of Care, University Hospitals of Geneva, Geneva, Switzerland
- Department of Sociology, Geneva School of Social Sciences, University of Geneva, Geneva, Switzerland
| | - Arnaud Iseli
- Division of Quality of Care, University Hospitals of Geneva, Geneva, Switzerland
| | - Johan N. Siebert
- Department of Medicine, University of Geneva, Geneva, Switzerland
- Division of Paediatric Emergency Medicine, Department of Women, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland
| | - Guy Haller
- Division of Quality of Care, University Hospitals of Geneva, Geneva, Switzerland
- Department of Medicine, University of Geneva, Geneva, Switzerland
| | - Stéphane Cullati
- Division of Quality of Care, University Hospitals of Geneva, Geneva, Switzerland
- Population Health Laboratory (#PopHealthLab), Faculty of Science and Medicine, University of Fribourg, Fribourg, Switzerland
| | - Delphine S. Courvoisier
- Division of Quality of Care, University Hospitals of Geneva, Geneva, Switzerland
- Department of Medicine, University of Geneva, Geneva, Switzerland
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Biduchak A, Chornenka Z, Hopko N, Alsalama MWO, Domanchuk T. Assessment of population satisfaction with medical care in conflict conditions. J Med Life 2024; 17:67-72. [PMID: 38737658 PMCID: PMC11080516 DOI: 10.25122/jml-2023-0193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Accepted: 10/17/2023] [Indexed: 05/14/2024] Open
Abstract
In the context of health care reform, the primary task is to ensure the delivery of high-quality medical services and good end results in the performance of individual physicians, structural units, and general medical services. The healthcare sector is one of the most socially significant spheres of functioning in every country. The problem of conflicts presents special social importance in this field, as a result of the rather close relationship between doctor and patient. The main objective of this study was to determine patients' satisfaction with the quality of healthcare at the primary level. The survey was conducted using an electronic questionnaire. The sample consisted of 1,146 residents of Chernivtsi and the Chernivtsi region, aged 18-56 and older. Almost half of the respondents (42.5%) offered a neutral overall rating of the quality of medical services at the primary care level. Only 25.5% gave a positive valuation of the quality of health care services they received, while 32% gave a negative evaluation. Patients' actions, opinions, and ideas shape and complement industry policies and the way they are implemented. In this context, if a dialogue is established among the main actors in the healthcare system, improvements in the system can be achieved, which will lead to better health and quality of life for people in the future.
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Affiliation(s)
- Anzhela Biduchak
- Department of Social Medicine and Health Organization, Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Zhanetta Chornenka
- Department of Social Medicine and Health Organization, Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Nataliya Hopko
- Department of Social Medicine and Health Organization, Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Mohammad Wathek Obed Alsalama
- Department of Internal Medicine, Physical Rehabilitation, Sports Medicine, Bukovinian State Medical University, Chernivtsi, Ukraine
| | - Tatiana Domanchuk
- Department of Social Medicine and Health Organization, Bukovinian State Medical University, Chernivtsi, Ukraine
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Kim DH, Kim B, Jang SY, Lee SG, Kim TH. Association between patient choice of provider and patient-reported experience. Int J Qual Health Care 2023; 35:mzad093. [PMID: 37952091 DOI: 10.1093/intqhc/mzad093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 10/06/2023] [Accepted: 11/10/2023] [Indexed: 11/14/2023] Open
Abstract
Health providers are striving to create a more positive, patient-centred experience. However, existing scholarly research about the association between determinants of patient choice of provider and patient-reported experience remains insufficient to effectively promote patient-centredness in healthcare systems. This study used a sample from the nationally representative 2020 Healthcare Experience Survey. Among the respondents (n = 12 133), 6809 who used outpatient services were selected for analysis. The variable of interest was the determinant of the patient choice of provider, and the dependent variables were patient-reported experiences (e.g. general satisfaction, experience with doctors, and experience with health providers and nurses). Data were analyzed using a multivariable logistic regression model by correcting for covariates. General satisfaction was positively associated with providers' expertise factors and public image factors [providers' expertise factors: odds ratio (OR), 2.96; 95% confidence interval (CI), 2.44-3.59; public image factors: OR, 1.26; 95% CI, 1.02-1.55] satisfied more general satisfaction. Similar results were found for experience with doctors (providers' expertise factors: OR, 4.50; 95% CI, 2.77-7.32; other factors: OR, 0.37; 95% CI, 0.16-0.81) and experience with health providers and nurses (providers' expertise factors: OR, 2.66; 95% CI, 1.99-3.57; image factors: OR, 1.53; 95% CI, 1.09-2.14). Our study's findings suggest that to improve patient-reported experience, health providers must better manage providers' expertise factors and public image factors. Health providers can improve patient-reported experience by increasing communication skills and proper information about the nature is important. Moreover, health providers must manage public image factors comprehensively and continuously by maintaining good quality of care and to brand patients.
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Affiliation(s)
- Do Hee Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea
| | - Bomgyeol Kim
- Department of Public Health, Graduate School, Yonsei University, Seoul 03722, Korea
| | - Suk-Yong Jang
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul 03722, Korea
| | - Sang Gyu Lee
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul 03722, Korea
| | - Tae Hyun Kim
- Department of Healthcare Management, Graduate School of Public Health, Yonsei University, Seoul 03722, Korea
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Crubezy M, Douay C, Michel P, Haesebaert J. Using patient comments from a standardised experience survey to investigate their perceptions and prioritise improvement actions: a thematic and syntactic analysis. BMC Health Serv Res 2023; 23:988. [PMID: 37710317 PMCID: PMC10503051 DOI: 10.1186/s12913-023-09953-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 08/22/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Although patient experience surveys flourish in many countries with the aim to improve quality of care, questions remain concerning their ability to become effective drivers of change within institutions. The patient comments from the French national patient experience hospital survey were analysed using an innovative structured approach to characterise patient experience and identify field actions for the institutions. METHODS The comments were taken from the two open-ended questions comprised in the patient experience survey of the Hospices Civils de Lyon between 2018 and 2019. The comments analysis methodology consisted in three steps: thematic analysis; syntactic analysis; generation of statistics for the creation of a patient journey and prioritisation of sub-themes. The STROBE statement checklist was followed. RESULTS Over a year, 79.7% of the 7 362 respondents left at least one comment at the end of the survey and were included in the study, for a total of 5 868 surveys and 10 061 comments. These led to the identification of 28 general themes and 184 specific sub-themes. From the patient journey created, 23 sub-themes were prioritised and gathered into four key categories: relationship between patient and staff; environment; surgery and pain management; information and care coordination. For each of them, the actions and expectations formulated by the respondents were described. CONCLUSIONS The analysis of patient comments obtained from a standardised survey allowed to characterise the patient journey using data that describes patient experience, enabling a prioritisation of actions aiming to improve practice and quality of care at the institution, department, and staff level.
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Affiliation(s)
- Marion Crubezy
- Research On Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France.
- Institut d'études KPAM, Paris, France.
| | | | - Philippe Michel
- Research On Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Direction Qualité Usagers Et Santé Populationnelle, Hospices Civils de Lyon, Lyon, France
| | - Julie Haesebaert
- Research On Healthcare Performance (RESHAPE), INSERM U1290, Université Claude Bernard Lyon 1, Lyon, France
- Pôle de Santé Publique, Service de Recherche Et Epidémiologie Cliniques, Hospices Civils de Lyon, Lyon, France
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van der Storm SL, Hensen N, Schijven MP. Patient satisfaction with stoma care and their expectations on mobile apps for supportive care. Colorectal Dis 2023; 25:1852-1862. [PMID: 37507846 DOI: 10.1111/codi.16658] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 04/25/2023] [Accepted: 05/17/2023] [Indexed: 07/30/2023]
Abstract
AIM Self-efficacy in stoma care is essential, as it reduces morbidity and psychosocial problems. Mobile applications (apps) may optimise patients' self-efficacy. This article investigates patients' satisfaction with stoma care, their attitudes towards a supporting app aiming to promote self-efficacy and evaluate which functionalities are desired. METHOD A survey was sent to members of the two stoma-related patient associations in the Netherlands. Associations between patient characteristics, satisfaction concerning received stoma care, and willingness to use an app were evaluated. RESULTS The survey was completed by 1868 patients. Overall satisfaction was scored as 6.6, with shortfalls reported in the preoperative information provision, stoma site selection, and postoperative care. Patients of older age, who were unaware of getting a stoma, had an ileostomy, a low quality of life or psychosocial problems, were less satisfied. An app was expected to be of added value by 59.4% of the patients having a stoma for less than three years, compared to the significantly lower 43.8% expectation rate of the remaining study population (p < 0.001). Moreover, patients with a high frequency of physical or psychosocial problems expressed higher levels of interest. CONCLUSION Patients were only moderately satisfied with their received stoma care. A supportive app is most likely beneficial for patients who had a stoma for less than three years, were in an acute situation, and/or have stoma-related problems. Most patients prefer information via internet or on paper, although apps may offer additional benefits. It is important to acknowledge digital literacy and to council patients appropriately about the benefits and help them to use apps.
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Affiliation(s)
- Sebastiaan L van der Storm
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
| | - Nikita Hensen
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Marlies P Schijven
- Department of Surgery, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Gastroenterology Endocrinology Metabolism, Amsterdam, The Netherlands
- Amsterdam Public Health, Digital Health, Amsterdam, The Netherlands
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11
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Crubezy M, Haesebaert J, Geig A, Michel P. [E-Satis : A new method for analysis of Patient-Reported Outcome Measures (PROMs)]. Rev Epidemiol Sante Publique 2023; 71:101839. [PMID: 37120979 DOI: 10.1016/j.respe.2023.101839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 03/13/2023] [Accepted: 03/13/2023] [Indexed: 05/02/2023] Open
Abstract
OBJECTIVE Almost 80% of the patients responding to the nationwide French patient experience and satisfaction survey (e-Satis) provided free text comments. The objective of this article is to describe an innovative methodology for analysis of this qualitative data. METHODOLOGY This methodological approach is based on analysis of qualitative data from the comments (verbatims) of respondents to the e-Satis survey. Analysis of the verbatims consists in three main steps: (i) analysis of the meaning of the words, with constitution of a thematic dictionary through exploratory research without preconceived notions; (ii) analysis of the syntax, i.e., the way in which the ideas are articulated, which will enable calculation of a linguistic indicator of speakers' involvement in their speech; (iii) production of statistics and characterisation of the themes, which will include three indicators: occurrence of the themes, the average satisfaction shown in the respondents' discourse, and the positive and negative involvement with which they express themselves. Given these results, a priority matrix of four categories of action is established: strong points, priority areas, good practices, and weak signals. RESULTS This methodological approach was applied to 5868 e-Satis questionnaires out of a total of 10,061 verbatims by respondents hospitalised at the Hospices Civils de Lyon between 2018 and 2019. The analysis identified 28 major themes with 184 sub-themes. An extract is presented in this article for illustration purposes. DISCUSSION A methodological approach based on analysis of qualitative data will enable transformation of unstructured data (verbatims) into measurable and comparable data. This methodology is structured to overcome the limitations of closed questions; open questions allow respondents to describe their experiences and perceptions in their own words. Moreover, it is a first step toward comparability of results over time with those of other establishments. This approach is unique in France on account of (a) its exploratory thematic research without preconceived notions and (b) its syntactic analysis of verbatims. CONCLUSIONS This verbatim analysis methodology should enable precise and operational characterization of Patient Experience and induce prioritized improvement actions in healthcare institutions.
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Affiliation(s)
- M Crubezy
- Research on Healthcare Performance (RESHAPE), Inserm U1290, Université Claude Bernard Lyon 1, 69008, Lyon, France; Institut d'études KPAM, 75002, Paris, France.
| | - J Haesebaert
- Research on Healthcare Performance (RESHAPE), Inserm U1290, Université Claude Bernard Lyon 1, 69008, Lyon, France; Pôle de santé publique et Service recherche épidémiologie cliniques, Hospices Civils de Lyon, 69002, Lyon, France
| | - A Geig
- Institut d'études KPAM, 75002, Paris, France
| | - P Michel
- Research on Healthcare Performance (RESHAPE), Inserm U1290, Université Claude Bernard Lyon 1, 69008, Lyon, France; Direction Qualité usagers et santé populationnelle, Hospices Civils de Lyon, 69002, Lyon, France
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Measuring Patient Experience and Patient Satisfaction—How Are We Doing It and Why Does It Matter? A Comparison of European and U.S. American Approaches. Healthcare (Basel) 2023; 11:healthcare11060797. [PMID: 36981454 PMCID: PMC10048416 DOI: 10.3390/healthcare11060797] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 01/12/2023] [Accepted: 02/28/2023] [Indexed: 03/12/2023] Open
Abstract
(1) Background: Patients’ experiences and satisfaction with their treatment are becoming increasingly important in the context of quality assurance, but the measurement of these parameters is accompanied by several disadvantages such as poor cross-country comparability and methodological problems. The aim of this review is to describe and summarize the process of measuring, publishing, and utilizing patient experience and satisfaction data in countries with highly developed healthcare systems in Europe (Germany, Sweden, Finland, Norway, the United Kingdom) and the USA to identify possible approaches for improvement. (2) Methods: Articles published between 2000 and 2021 that address the topics described were identified. Furthermore, patient feedback in social media and the influence of sociodemographic and hospital characteristics on patient satisfaction and experience were evaluated. (3) Results: The literature reveals that all countries perform well in collecting patient satisfaction and experience data and making them publicly available. However, due to the use of various different questionnaires, comparability of the results is difficult, and consequences drawn from these data remain largely unclear. (4) Conclusions: Surveying patient experience and satisfaction with more unified as well as regularly updated questionnaires would be helpful to eliminate some of the described problems. Additionally, social media platforms must be considered as an increasingly important source to expand the range of patient feedback.
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13
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Padilla-Fortunatti C, Rojas-Silva N, Molina-Muñoz Y, Avendaño-Jara S. Cultural adaptation and psychometric properties of the Chilean-Spanish version of the Family Satisfaction in the Intensive Care Unit - 24 questionnaire. Med Intensiva 2023; 47:140-148. [PMID: 36068147 DOI: 10.1016/j.medine.2022.07.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/31/2022] [Accepted: 02/03/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To adapt and validate the Spanish version of the Family Satisfaction in the Intensive Care Unit - 24 (FS ICU-24) questionnaire among relatives of critically ill patients in a teaching hospital in Chile. DESIGN Prospective observational study aimed to validate a measuring instrument. SETTING Medical-surgical intensive care unit (ICU) of a teaching hospital in Chile. PATIENTS OR PARTICIPANTS Two hundred and forty relatives of critically ill patients with at least48 h in the ICU, older than 18 years, and with at least one visit to the patient. INTERVENTIONS None. MAIN VARIABLES OF INTEREST Content validity, construct validity, and reliability analysis of the Spanish version of the FS ICU-24 were evaluated. RESULTS The Spanish version of the FS ICU-24 was adapted, improving its understanding and clarity. The factor analysis showed an optimal solution of 3 factors for the Chilean-Spanish version of the FS ICU-24, which explain 51% of the total variance. Reliability was adequate for the global scale (α = 0.93) and the dimensions of satisfaction with patient and family care (α = 0.82), satisfaction with communication (α = 0.91) and satisfaction with decision-making (α = 0.71). CONCLUSIONS The Chilean-Spanish version of the FS ICU-24 proved to be valid and reliable for the evaluation of family satisfaction in the ICU. Having a valid instrument will allow health institutions to accurately identify areas for improvement in the care of the family members and the critically ill patient.
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Affiliation(s)
| | - Noelia Rojas-Silva
- Escuela de Enfermería, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
| | - Yerko Molina-Muñoz
- Escuela de Psicología, Universidad Adolfo Ibáñez, Peñalolén, Santiago, Chile
| | - Stefany Avendaño-Jara
- Escuela de Enfermería, Pontificia Universidad Católica de Chile, Macul, Santiago, Chile
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14
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Patient Satisfaction with Healthcare Services and the Techniques Used for its Assessment: A Systematic Literature Review and a Bibliometric Analysis. Healthcare (Basel) 2023; 11:healthcare11050639. [PMID: 36900644 PMCID: PMC10001171 DOI: 10.3390/healthcare11050639] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 02/15/2023] [Accepted: 02/18/2023] [Indexed: 02/24/2023] Open
Abstract
Patient satisfaction with healthcare provision services and the factors influencing it are be-coming the main focus of many scientific studies. Assuring the quality of the provided services is essential for the fulfillment of patients' expectations and needs. Thus, this systematic review seeks to find the determinants of patient satisfaction in a global setting. We perform an analysis to evaluate the collected literature and to fulfill the literature gap of bibliometric analysis within this theme. This review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) approach. We conducted our database search in Scopus, Web of Science, and PubMed in June 2022. Studies from 2000-2021 that followed the inclusion and exclusion criteria and that were written in English were included in the sample. We ended up with 157 articles to review. A co-citation and bibliographic coupling analysis were employed to find the most relevant sources, authors, and documents. We divided the factors influencing patient satisfaction into criteria and explanatory variables. Medical care, communication with the patient, and patient's age are among the most critical factors for researchers. The bibliometric analysis revealed the countries, institutions, documents, authors, and sources most productive and significant in patient satisfaction.
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15
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Aljohani M, Donnelly M, O’Neill C. Changes in public satisfaction with GP services in Britain between 1998 and 2019: a repeated cross-sectional analysis of attitudinal data. BMC PRIMARY CARE 2022; 23:83. [PMID: 35436843 PMCID: PMC9014779 DOI: 10.1186/s12875-022-01696-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 04/05/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
Between 1998 and 2019, the structure and process of general practitioner services in Britain underwent a series of reforms and experienced distinct funding environments. This paper examines changes in satisfaction with GP services over time against this backdrop.
Methods
Data were extracted from the British Social Attitudes Survey for the period 1998–2019. Logistic regression analyses investigated changes in overall satisfaction and among specific population sub-groups differentiated by socio-demographic characteristics whilst taking account of time trend and interaction effects between sub-group membership and time trend.
Results
Sustained and significant changes in satisfaction coincided closely with changes to the funding environment. Distinct patterns were evident among sub-groups. Satisfaction appeared to fall more sharply during austerity for low income groups, older people and people who had fewer formal qualifications/years in education.
Conclusion
While a series of policy initiatives were adopted over the period examined, public satisfaction seemed to move in a manner consistent with levels of government expenditure rather than exhibiting distinct breaks that coincided with policy initiatives. As services recover from the pandemic it will be necessary to invest in a significant and sustained way to rebuild public satisfaction.
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16
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Dwivedi G, Sood A, Patnaik U, Kumari A. Assessment of Level of Patient Satisfaction with Day-Care Surgery: An Observational Study. Indian J Otolaryngol Head Neck Surg 2022; 74:5252-5257. [PMID: 36742571 PMCID: PMC9895141 DOI: 10.1007/s12070-020-01972-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 07/13/2020] [Indexed: 02/07/2023] Open
Abstract
To assess the level of patient satisfaction with day-care surgery at a tertiary care centre and to find out the different determinants that influence the patient satisfaction. Observational study; Tertiary care hospital in Western India; Patients undergoing Day-care surgery at Dept of ENT from Feb 2018 to Aug 2018; All patients who underwent day-care surgery were given a questionnaire to determine level of satisfaction. On analysis of data according to questions the average score was in the range of 3.5 to 4.22 out of a maximum score of 5. On analysis of data according to domains of patient care the scores ranged from 3.61 to 4.19. Although patients were generally satisfied with the level of care being provided to them there is still scope of improvement.
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Affiliation(s)
- Gunjan Dwivedi
- Department of ENT Command Hospital Southern Command, Pune, India
| | - Amit Sood
- Department of ENT Command Hospital Southern Command, Pune, India
| | - Uma Patnaik
- Department of ENT Command Hospital Southern Command, Pune, India
| | - Abha Kumari
- Department of ENT Command Hospital Southern Command, Pune, India
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17
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Goodrich GW, Lazenby JM. Elements of patient satisfaction: An integrative review. Nurs Open 2022; 10:1258-1269. [PMID: 36306415 PMCID: PMC9912404 DOI: 10.1002/nop2.1437] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 02/26/2022] [Accepted: 10/09/2022] [Indexed: 11/05/2022] Open
Abstract
AIM To summarize the scientific literature on the elements essential to understanding a nursing definition of patient satisfaction. DESIGN Whittemore and Knafl's methodology was used for this integrative review. METHODS Articles were included if the studies they explored patient satisfaction in patient populations and measured patient satisfaction using standardized, validated instruments. Elements in this review were defined as the essential components that create the complex concept of patient satisfaction. RESULTS Thirty articles were found and analysed in full. Five definitions of patient satisfaction were used, all of which were at least 20 years old. Twenty-two different measures of patient satisfaction were used, six of which were nursing-specific. Sixty-eight elements of patient satisfaction were studied in the included articles. Forty-three elements were reported as having a significant relationship with patient satisfaction, 25 were reported as having no significant relationship. Eight elements had both significant and non-significant relationships.
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Affiliation(s)
| | - James Mark Lazenby
- University of California Irvine Sue & Bill Gross School of NursingIrvineCaliforniaUSA
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18
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Pettegrew LS, Clements ML, Scacco JM, Miller R. Assessing Patient Satisfaction: Using the Radiation Oncology Patient Satisfaction [ROPS] Questionnaire in a Private Practice Setting. Health Serv Insights 2022; 15:11786329221118241. [PMID: 35983072 PMCID: PMC9379964 DOI: 10.1177/11786329221118241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2022] [Accepted: 07/19/2022] [Indexed: 11/26/2022] Open
Abstract
A new patient satisfaction measure called the Radiation Oncology Patient Satisfaction (ROPS) questionnaire is used in this study to measure satisfaction data for radiation oncology in private practice. Limitations of existing literature on patient satisfaction demonstrated a need to develop a questionnaire that was more tailored to analyze patient satisfaction among those utilizing private oncology centers within the U.S. healthcare system. This need was met by this study's development of the ROPS questionnaire, which was a variation of 2 existing constructs that are presented in the text. The questionnaire was fielded among patients at a private cancer radiation treatment clinic in Florida (n = 950). Data analysis tested the psychometric properties of our revised construct and its predictive validity for 2 patient satisfaction outcomes: (1) likelihood of recommending this treatment center to family members/close friends and (2) overall satisfaction with treatment. Each of the ROPS variables were found to make a legitimate contribution to evaluating patients' overall satisfaction with radiation treatment. Findings indicated organizational setting was of vital importance when conducting patient- centered research on satisfaction. Treatment factors in ROPS can be adjusted to measure satisfaction with chemotherapy or other modalities in addition to radiation treatment. Authors recommend radiation oncology clinics regularly monitor patient satisfaction, especially if/when they experience organizational changes, such as when a new physician joins the practice or if/when the national or local landscape undergoes significant shifts in norms and expectations like we have seen happen with COVID-19.
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19
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Gargallo-Puyuelo CJ, García-Mateo S, Martinez-Domínguez SJ, Gomollón F. Is the gender or age of the physician key to a good physician–patient with inflammatory bowel disease relationship? GASTROENTEROLOGÍA Y HEPATOLOGÍA 2022; 46:261-265. [PMID: 35964814 DOI: 10.1016/j.gastrohep.2022.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 07/18/2022] [Accepted: 07/20/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND AIMS A good patient-physician relationship in inflammatory bowel disease (IBD) is very important and physician empathy is its cornerstone. There is no evidence about if age and/or sex of physicians and patients could influence on perceived empathy by patients. The aim of the study was to assess the level of empathy of IBD specialist physicians perceived by their patients and if it varies according to the age and gender of the patient and the physician. METHODS We performed a national cross-sectional study based on voluntary online survey to IBD patients that included the Consultation and Relational Empathy (CARE) scale. RESULTS Five hundred sixty one responses to the survey were received. After applying exclusion criteria, 536 patients were included in the analysis. Total median score of CARE scale was 44.5 (maximum possible score: 50 points). Most of the patients (99.1%) considered the contents of the questionnaire to be an important issue. There were no significant differences in CARE scale scores in function of patient/physician age range or gender [physician gender: males vs. females: median 46 vs. 44, p=0.139; physician age: <40 years, 40-60 years, >60 years: 45.5 vs. 44 vs. 44, p=0.328]. CONCLUSION Spanish inflammatory bowel disease patients have a great physician empathy perception, which is the key to a good patient-physician relationship, and this fact is not influenced by age or gender of patients or inflammatory bowel disease specialist.
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20
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Almutairi M, McKenna G, O'Neill C. Satisfaction with dental care services in Great Britain 1998-2019. BMC Oral Health 2022; 22:308. [PMID: 35883074 PMCID: PMC9315088 DOI: 10.1186/s12903-022-02343-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 07/20/2022] [Indexed: 11/26/2022] Open
Abstract
Background Satisfaction with dental services can provide valuable insights into aspects of quality including access as well as changes in this over time. In the UK publicly funded dental services are ostensibly delivered by private sector general dental practitioners for whom private patients represent an opportunity cost to the provision of care to public patients. This study examined changes in satisfaction as economic circumstances and policy changed in Britain between 1998 and 2019. Methods Data were taken from successive waves of the British Social Attitudes Survey a representative cross-sectional survey of the population between 1998 and 2019. Descriptive statistics and a series of logistic regression analyses were used to examine the relationships between satisfaction and a range of socio-demographic characteristics over time. Results 37,328 usable responses were extracted from the survey spanning 21 years of data. Over the course of the survey approximately 71% of the sample was very satisfied, satisfied or neither satisfied nor dissatisfied with publicly funded dental services. Satisfaction fell at the outset of the study period but rose following the economic downturn from 2008 which coincided with increased use of publicly funded services. Differences were evident in satisfaction between older versus younger respondents, more affluent versus less affluent respondents and better educated versus less well-educated respondents. Satisfaction did not appear to change in response to policy changes. Conclusion Satisfaction is an important outcome of service provision. Policies aiming to improve satisfaction with publicly funded dental care in the UK must take account of the competing demands on dentists’ time from private patients. At times of economic expansion or when supply has been disrupted, these may be particularly acute and require specific interventions to improve access for those who depend on public services. Supplementary Information The online version contains supplementary material available at 10.1186/s12903-022-02343-7.
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Affiliation(s)
- Majed Almutairi
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK. .,Public Health Department, School of Health Sciences, Saudi Electronic University, Riyadh, Saudi Arabia.
| | - Gerry McKenna
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
| | - Ciaran O'Neill
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
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21
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Novel Patient-Reported Outcome Measures for the Assessment of Patient Satisfaction and Health-Related Quality of Life Following Postmastectomy Breast Reconstruction. Aesthetic Plast Surg 2022; 46:1588-1599. [PMID: 35879476 DOI: 10.1007/s00266-022-02985-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 06/04/2022] [Indexed: 11/01/2022]
Abstract
BACKGROUND Patient-reported outcome measures (PROMs) have become an integral part of the evaluation of reconstruction surgery outcomes. However, there are limitations in current PROMs when it comes to the assessment of well-being during inpatient stay, patient perception of health, relationship with partner, and vitality (i.e., mood and ability to work and pursue hobbies, carry out daily tasks, and sleep) following breast reconstructive surgery. The aim was to develop a novel set of measures to compare patient satisfaction and health-related quality of life following different types of postmastectomy breast reconstruction. METHODS A novel questionnaire was created and refined through cognitive interviews with patients and expert feedback. A field test study was conducted, including patients who had undergone delayed postmastectomy breast reconstruction with implant, autologous tissue, or combination of implant and autologous tissue. Based on the results, confirmatory factor analysis and examination of reliability of the questionnaire were conducted. Results of patient responses were analyzed using Chi-square test, Kruskal-Wallis test, and Mann-Whitney U test. RESULTS Confirmatory factor analysis showed good model fit, and Cronbach's alpha indicated high internal consistency of the questionnaire. Besides that, patients with combination reconstruction reported significantly lower vitality than patients with implant and autologous reconstruction (p = 0.048). CONCLUSIONS This novel questionnaire expands the current knowledge base of postmastectomy breast reconstruction PROMs. Results of the field test study showed that combination reconstruction was associated with lower patient vitality than other reconstruction types. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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22
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Olesen K, Bathula H. A meta-analysis of the determinants of patient satisfaction and loyalty. Health Mark Q 2022; 39:191-210. [PMID: 35306972 DOI: 10.1080/07359683.2022.2050000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
In the contemporary competitive environment, healthcare providers have had to ensure that their customers are satisfied with the quality of medical service they receive as this is critical in customer retention and their repeated use of the service of the healthcare provider. Taking the patient's perspective, several studies have attempted to identify the determinants of patient satisfaction and their loyalty toward healthcare providers. Studies have yielded mixed results and to get a clearer understanding of these relationships, we perform a meta-analysis of 13 studies to test nine hypotheses. We discuss the implications of the results.
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Affiliation(s)
- Karin Olesen
- Graduate School of Management, The University of Auckland, Auckland, New Zealand
| | - Hanoku Bathula
- Graduate School of Management, The University of Auckland, Auckland, New Zealand
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23
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Padilla-Fortunatti C, Rojas-Silva N, Molina-Munoz Y, Avendano-Jara S. Adaptación cultural y propiedades psicométricas de la versión en español-chileno del cuestionario Family Satisfaction in the Intensive Care Unit – 24. Med Intensiva 2022. [DOI: 10.1016/j.medin.2022.02.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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24
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Xu J, Park S, Xu J, Hamadi H, Zhao M, Otani K. Factors Impacting Patients' Willingness to Recommend: A Structural Equation Modeling Approach. J Patient Exp 2022; 9:23743735221077538. [PMID: 35128045 PMCID: PMC8814971 DOI: 10.1177/23743735221077538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Patient ratings of inpatient stay have been the focus of prior research since better patient satisfaction results in a financial benefit to hospitals and are associated with better patient health care outcomes. However, studies that simultaneously account for within- and between-hospital effects are uncommon. We constructed a multilevel structural equation model to identify predictors of patients’ willingness to recommend a hospital at both within-hospital and between-hospital levels. We used data from 60 U.S. general medical and surgical hospitals and 12,115 patients. Multilevel structural equation modeling reported that patient ratings on the overall quality of care significantly affect the willingness to recommend within hospitals. Also, patients’ perspectives on the hospital environment and nursing are the significant factors that predict the patient ratings on the overall quality of care. Overall patient satisfaction significantly predicts the willingness to recommend at the between-hospital level, whereas hospital size and location have marginal impacts.
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Affiliation(s)
- Jing Xu
- Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - Sinyoung Park
- Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - Jie Xu
- Clinical Science, Johnson & Johnson Vision, Jacksonville, FL, USA
| | - Hanadi Hamadi
- Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - Mei Zhao
- Department of Health Administration, Brooks College of Health, University of North Florida, Jacksonville, FL, USA
| | - Koichiro Otani
- Department of Public Policy, Purdue University Fort Wayne, IN, USA
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García-Corchero JD, Jiménez-Rubio D. How do policy levers shape the quality of a national health system? JOURNAL OF POLICY MODELING 2022; 44:203-221. [PMID: 34703065 PMCID: PMC8529896 DOI: 10.1016/j.jpolmod.2021.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 04/23/2021] [Accepted: 09/12/2021] [Indexed: 06/13/2023]
Abstract
Poor quality of care may have a detrimental effect on access and take-up and can become a serious barrier to the universality of health services. This consideration is of particular interest in view of the fact that health systems in many countries must address a growing public-sector deficit and respond to increasing pressures due to COVID-19 and aging population, among other factors. In line with a rapidly emerging literature, we focus on patient satisfaction as a proxy for quality of health care. Drawing on rich longitudinal and cross-sectional data for Spain and multilevel estimation techniques, we show that in addition to individual level differences, policy levers (such as public health spending and the patient-doctor ratio, in particular) exert a considerable influence on the quality of a health care system. Our results suggest that policymakers seeking to enhance the quality of care should be cautious when compromising the level of health resources, and in particular, health personnel, as a response to economic downturns in a sector that traditionally had insufficient human resources in many countries, which have become even more evident in the light of the current health crisis. Additionally, we provide evidence that the increasing reliance on the private health sector may be indicative of inefficiencies in the public system and/or the existence of features of private insurance which are deemed important by patients.
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Affiliation(s)
- Juan David García-Corchero
- Departamento de Economía Aplicada, Facultad de Ciencias Económicas y Empresariales, Campus de Cartuja, Spain
| | - Dolores Jiménez-Rubio
- Departamento de Economía Aplicada, Facultad de Ciencias Económicas y Empresariales, Campus de Cartuja, Spain
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Sancassiani F, Gambino S, Lindert J, Sali L, Pinna I, Origa G, Cossu G, Scartozzi M, Preti A. The Reliability and Test-Retest Stability of the Treatment Perception Questionnaire (TPQ) in the Oncology Field: A Pilot Study. Clin Pract Epidemiol Ment Health 2021; 17:324-330. [PMID: 35444706 PMCID: PMC8985465 DOI: 10.2174/1745017902117010324] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 07/08/2021] [Accepted: 07/09/2021] [Indexed: 11/22/2022]
Abstract
Background:
Patients' satisfaction is an indicator of technical, instrumental, environmental, and interpersonal aspects of care. It shows how much the health service “as a whole organization” meets the patients’ psychosocial expectations and if the health professionals combine their technical competence with relational skills. The Treatment Perception Questionnaire (TPQ) is a brief instrument developed in the United Kingdom for research with substance abuse disorder populations. The present study aimed at evaluating the reliability and test-retest stability of the TPQ Italian translation in a sample of patients with solid and blood cancers.
Methods:
The TPQ was administered to 263 people with solid and blood cancers. Test-retest reliability was evaluated in a subgroup of 116 participants who completed the TPQ again after 3 months.
Results:
The reliability of TPQ was good. Cronbach’s alpha: 0.83 (95%CI: 0.79-0.86), 0.66 (0.59-0.72), 0.71 (0.65-0.769), respectively, in the total test, and in subscales on “staff perception”, and “program perception”. Test-retest reliability was 0.82 (0.77-0.87). The mean difference between the first and the second assessment was 1.0 (SD = 7.1; 95% CI -0.35 to 2.33). By plotting the differences and the means of the two assessments, 5/116 cases (4.3%) were outside the upper and lower limits of agreement.
Conclusions:
This study points out good reliability and test-retest stability of the TPQ in the oncology field. The TPQ can be used to assess variation over time about satisfaction with care in patients with oncological diseases, favoring the identification of unmet patients’ needs about the quality of the service.
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Sehngelia L, Pavlova M, Groot W. Women’s satisfaction with maternal care services in Georgia. HEALTH POLICY OPEN 2021. [DOI: 10.1016/j.hpopen.2020.100028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
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Lin YH, Chen HC, Hsu NW, Tsao HM, Lo SS, Chou P. Depression and anxiety correlate differentially with dissatisfaction with healthcare services in older adults: The Yilan Study, Taiwan. J Formos Med Assoc 2021; 121:1506-1514. [PMID: 34782197 DOI: 10.1016/j.jfma.2021.10.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 10/01/2021] [Accepted: 10/25/2021] [Indexed: 01/25/2023] Open
Abstract
BACKGROUND/PURPOSE Previous studies have seldom investigated the psychological factors that are associated with dissatisfaction with healthcare services. We therefore examined the associations of depression and anxiety with service dissatisfaction among older adults. METHODS A community-based health survey was conducted from 2012 to 2016. Residents aged ≥65 years were randomly recruited from Yilan City, Taiwan. Besides overall dissatisfaction, we assessed dissatisfaction with physicians' ability, physicians' attitude, and waiting time. The Hospital Anxiety and Depression Scale was used to detect depressive and anxiety symptoms with optimal cut-off points of 3 for the anxiety subscale and 6 for the depression subscales. RESULTS Of the 3480 residents included in this study, the overall dissatisfaction rate was 7.9%. After controlling for covariates, depressive and anxiety symptoms were consistently correlated with the various dimensions of dissatisfaction. More specifically, depressive symptoms were associated with overall dissatisfaction and dissatisfaction with physicians' ability and attitude. Conversely, anxiety was uniquely associated with dissatisfaction with waiting time. CONCLUSION Psychological symptoms were consistent correlates of dissatisfaction with healthcare services among older adults, although the specific symptoms had different associations with the various dimensions of dissatisfaction.
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Affiliation(s)
- Yen-Huai Lin
- Department of Medical Imaging, Cheng Hsin General Hospital, Taipei, Taiwan; Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Hsi-Chung Chen
- Department of Psychiatry and Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Nai-Wei Hsu
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan; Institute of Public Health and Community Medicine Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan; Public Health Bureau, Yilan, Taiwan.
| | - Hsuan-Ming Tsao
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Division of Cardiology, Department of Internal Medicine, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
| | - Su-Shun Lo
- Department of Medicine, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan; Department of Surgery, National Yang Ming Chiao Tung University Hospital, Yilan, Taiwan
| | - Pesus Chou
- Institute of Public Health and Community Medicine Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan
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Agarwal N, Rahman A, Jacobs R, Taylor T, Muthiah N, Alan N, Ozpinar A, Fields D, Hamilton DK. Patient perception of scoliosis correction surgery on Instagram. Neurosurg Focus 2021; 51:E6. [PMID: 34724639 DOI: 10.3171/2021.8.focus201015] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 08/31/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Patient feedback surveys provide important insight into patient outcomes, satisfaction, and perioperative needs. Recent critiques have questioned provider-initiated surveys and their capacity to accurately gauge patient perspectives due to intrinsic biases created by question framing. In this study, the authors sought to evaluate provider-independent, patient-controlled social media Instagram posts in order to better understand the patient experience following scoliosis correction surgery. METHODS Twitter and Instagram were queried for posts with two tagged indicators, #scoliosissurgery or @scoliosissurgery, resulting in no relevant Twitter posts and 25,000 Instagram posts. Of the initial search, 24,500 Instagram posts that did not directly involve the patient's own experience were eliminated. Posts were analyzed and coded for the following criteria: the gender of the patient, preoperative or postoperative timing discussed in the post, and classified themes related to the patient's experiences with scoliosis correction surgery. RESULTS Females made 87.6% of the Instagram posts about their experience following scoliosis correction surgery. The initial postoperative stage of surgery was mentioned in 7.6% of Instagram posts. The most common theme on Instagram involved offering or seeking online support from other patients, which constituted 85.2% of all posts. Other common themes included concern about the surgical scar (31.8%), discussing the results of treatment (28.8%), and relief regarding results (21.2%). CONCLUSIONS Social media provided a platform to analyze unprompted feedback from patients. Patients were most concerned with their scoliosis correction surgery in the period of time 2 weeks or more after surgery. Themes that were most commonly found on Instagram posts were offering or seeking online support from other patients and concern about the surgical scar. Patient-controlled social media platforms, like Instagram, may provide a useful mechanism for healthcare providers to understand the patient experience following scoliosis correction surgery. Such platforms may help in evaluating postoperative satisfaction and improving postoperative quality of care.
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Shaqura II, Jaafaripooyan E, Hosseini M, Shagora AERS, Sari AA. Nurses' Perspectives on Inpatient Care Responsiveness at the Gazan Public Hospitals. Ethiop J Health Sci 2021; 31:847-856. [PMID: 34703185 PMCID: PMC8512949 DOI: 10.4314/ejhs.v31i4.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Accepted: 01/10/2021] [Indexed: 11/17/2022] Open
Abstract
Background Responsiveness is one of the intrinsic goals of health systems. This study aimed at assessing the responsiveness of inpatient care in accordance to nurses' perspectives, particularly in internal medicine ‘medical’ and surgical departments, at the Gazan public general hospitals in 2020. Methods This cross-sectional descriptive study was conducted at 5 public general hospitals in Gaza. Data were collected from 277 nurses using an interview-based questionnaire composed mainly of 36 items to measure responsiveness on a 4-point Likert scale. Descriptive statistics, independent t-test and analysis of variance (ANOVA) using SPSS 22.0. Results The overall responsiveness was about 77.5%. Access to social support was the highest-performing domain but it was the less important. Dignity was the second-highest in performance but the most important domain. Choice of provider and quality of basic amenities were almost the lowest in both performance and importance. Hospital, marital status, educational level, position at work, income, department, and the experience in the current ward have led to significant differences in the level of responsiveness. Conclusion Supply-side should be considered to delineate the status quo of responsiveness accurately. There is a room for further improvement in the interpersonal domains of responsiveness without extravagant expenditures. Policymakers need to emphasize on better allocation of budget for client-orientation domains of responsiveness as well. Hospital characteristics had a pivotal role in creating significant differences among respondents. Likewise, socioeconomic status and cultural diversity of nurses led to significant variations in their responses, hence, this calls for robust and well-designed researches, including non-public hospitals, to determine the most influential factors.
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Affiliation(s)
- Iyad Ibrahim Shaqura
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Jaafaripooyan
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mostafa Hosseini
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Ali Akbari Sari
- Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Does Emotional Intelligence of Dental Undergraduates Influence Their Patient Satisfaction? Int J Dent 2021; 2021:4573459. [PMID: 34608391 PMCID: PMC8487387 DOI: 10.1155/2021/4573459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 08/25/2021] [Accepted: 09/18/2021] [Indexed: 12/30/2022] Open
Abstract
Objectives The research aimed to investigate if emotional intelligence (EI) scores of dental undergraduates influenced their patients' satisfaction with the treatment received. Methods A 33-item EI questionnaire was completed by 46 dental undergraduates in a cross-sectional study. Responses, measured on a five-point Likert scale, were summed to yield EI scores. Patients treated by the same undergraduates were invited to complete a patient satisfaction (PS) questionnaire. EI and PS scores were calculated and compared by undergraduates' gender and the patients' age and education status. The four EI factors (optimism/mood regulation, appraisal of emotions, utilization of emotions, and social skills of students) were correlated with PS using Spearman's correlation test with a significance level set at p < 0.05. Results EI scores did not differ significantly between male (N = 23) and female (N = 23) undergraduates (p=0.218). PS was not associated with patients' gender, but those educated to the secondary school level were more likely to be satisfied compared to those educated to the college/university level (p=0.022). Of the four EI factors, optimism/mood regulation was positively correlated with PS (p=0.049). Conclusion The results of the study suggest that the EI of the students can influence PS. Practical Implications. Interventions to enhance EI can be developed to improve the patient experience.
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Assessment of Accuracy of a Physician Ratings Website in One Metropolitan Area. J Surg Res 2021; 268:521-526. [PMID: 34461603 DOI: 10.1016/j.jss.2021.07.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2021] [Revised: 07/05/2021] [Accepted: 07/27/2021] [Indexed: 11/23/2022]
Abstract
BACKGROUND Patients frequently use online physician ratings websites (PRWs) to identify physicians for care. PRWs provide physician information and reviews. However, the accuracy of PRWs is uncertain. We investigated the accuracy and validity of Healthgrades with respect to endocrine surgery. We identified factors associated with reported board certification inaccuracy, higher ratings, greater quantity of ratings. MATERIALS AND METHODS The search term "endocrine surgery specialist" was used and the search was limited to a 25-mile radius around Philadelphia, PA. Data was collected on physician sex, age, board certification, surgical specialty, quantity of ratings, average rating, response to comments, and provision of a self-description. Descriptive statistics were performed to examine surgeon characteristics, ratings, and reported board certifications. Board certification accuracy was determined by searching the corresponding American Board website and calculating a kappa statistic. Logistic regression was performed to identify factors associated with board certification inaccuracy, higher average ratings, and higher quantity of ratings. RESULTS A total of 300 physicians were identified. Eighty-four percent of listed board certifications were accurate; the kappa statistic for accuracy of board certification was 0.634. Providing a response to comments and greater quantity of ratings were associated with higher average ratings. Provision of a self-description, male sex, and younger age were identified as factors associated with higher quantity of ratings. CONCLUSIONS A wide range of specialties are identified as endocrine surgery specialists. The reliability of board certification reporting was moderate. Increased surgeon involvement with the Healthgrades site was inconsistently associated with higher average ratings and higher quantity of ratings but lower accuracy.
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Welzel FD, Bär J, Stein J, Löbner M, Pabst A, Luppa M, Grochtdreis T, Kersting A, Blüher M, Luck-Sikorski C, König HH, Riedel-Heller SG. Using a brief web-based 5A intervention to improve weight management in primary care: results of a cluster-randomized controlled trial. BMC FAMILY PRACTICE 2021; 22:61. [PMID: 33794781 PMCID: PMC8017625 DOI: 10.1186/s12875-021-01404-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/25/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND The primary health care setting is considered a major starting point in successful obesity management. However, research indicates insufficient quality of weight counseling in primary care. Aim of the present study was to implement and evaluate a 5A online tutorial aimed at improving weight management and provider-patient-interaction in primary health care. The online tutorial is a stand-alone low-threshold minimal e-health intervention for general practitioners based on the 5As guidance for obesity management by the Canadian Obesity Network. METHODS In a cluster-randomized controlled trial, 50 primary care practices included 160 patients aged 18 to 60 years with obesity (BMI ≥ 30). The intervention practices had continuous access to the 5A online tutorial for the general practitioner. Patients of control practices were treated as usual. Primary outcome was the patients' perspective of the doctor-patient-interaction regarding obesity management, assessed with the Patient Assessment of Chronic Illness Care before and after (6/12 months) the training. Treatment effects over time (intention-to-treat) were evaluated using mixed-effects linear regression models. RESULTS More than half of the physicians (57%) wished for more training offers on obesity counseling. The 5A online tutorial was completed by 76% of the physicians in the intervention practices. Results of the mixed-effects regression analysis showed no treatment effect at 6 months and 12 months' follow-up for the PACIC 5A sum score. Patients with obesity in the intervention group scored lower on self-stigma and readiness for weight management compared to participants in the control group at 6 months' follow-up. However, there were no significant group differences for weight, quality of life, readiness to engage in weight management, self-stigma and depression at 12 months' follow-up. CONCLUSION To our knowledge, the present study provides the first long-term results for a 5A-based intervention in the context of the German primary care setting. The results suggest that a stand-alone low-threshold minimal e-health intervention for general practitioners does not improve weight management in the long term. To improve weight management in primary care, more comprehensive strategies are needed. However, due to recruitment difficulties the final sample was smaller than intended. This may have contributed to the null results. TRIAL REGISTRATION The study has been registered at the German Clinical Trials Register (Identifier: DRKS00009241 , Registered 3 February 2016).
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Affiliation(s)
- Franziska D Welzel
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany.
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany.
| | - Jonathan Bär
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Janine Stein
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Margrit Löbner
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Melanie Luppa
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
| | - Thomas Grochtdreis
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Anette Kersting
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
- Clinic for Psychosomatic Medicine and Psychotherapy, University of Leipzig, Leipzig, Germany
| | - Matthias Blüher
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
- Department of Endocrinology, Nephrology, Rheumatology, University Hospital Leipzig, Leipzig, Germany
| | - Claudia Luck-Sikorski
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
- Integrated Research and Treatment Centre (IFB) AdiposityDiseases, Leipzig University Medical Center, Leipzig, Germany
- SRH University of Applied Sciences Gera, Gera, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Philipp-Rosenthal-Straße 55, 04103, Leipzig, Germany
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Liu M, Hu L, Guo R, Wang H, Cao M, Chen X, Liu Y. The Influence of Patient and Hospital Characteristics on Inpatient Satisfaction at Beijing District-Level Hospitals. Patient Prefer Adherence 2021; 15:1451-1460. [PMID: 34234418 PMCID: PMC8253896 DOI: 10.2147/ppa.s314910] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 06/04/2021] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Patient satisfaction is a key indicator of healthcare quality and hospital performance. This study aims to assess inpatient satisfaction at district-level hospitals and explore the determinants of inpatient satisfaction. PATIENTS AND METHODS A total of 1458 adults from inpatient departments of 47 district-level hospitals in 16 districts across Beijing were recruited with a multi-stage stratified sample at Beijing in 2019. Univariate analysis and multivariate logistic regression were used to identify the influence of patient and institutional characteristics on inpatient satisfaction in four domains - administrative process, hospital environment, medical care, hospitalization expenses, and overall satisfaction. RESULTS Of the 1458 participants, 577 (39.6%) were men, 581 (39.8%) were over 60 years of age. The average value of satisfaction score measured by a 5-point Likert scale were 4.37, 4.00, 4.44, 3.89, and 4.33 for the four domains and overall satisfaction. Patient and institutional characteristics were strongly associated with inpatient satisfaction. Patients with higher educational level were more satisfied with administrative process (P<0.05). Elder patients and patients with worse self-reported health status were less satisfied with hospital environment (P<0.05). Female, higher monthly family income and Urban Employees Basic Medical Insurance were positively associated with patient satisfaction in hospitalization expenses (P<0.05). And patients receiving care in suburban hospitals were less satisfied with administrative process, hospital environment and overall satisfaction (P<0.05). Patients receiving care in Traditional Chinese Medicine hospitals were more satisfied with medical care and expenses but less satisfied with environment (P<0.05). Chronic disease and hospital grade were not significantly associated with satisfaction in all domains. CONCLUSION Patient satisfaction was influenced by demographic characteristics and hospital features. These determinants should be considered in hospital evaluation.
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Affiliation(s)
- Meicen Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Linlin Hu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
- Correspondence: Linlin Hu Chinese Academy of Medical Sciences and Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing, 100730, People’s Republic of ChinaTel +86-13-661229049Fax +86-65105830 Email
| | - Ran Guo
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Huanqian Wang
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Man Cao
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Xinyue Chen
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
| | - Yuanli Liu
- School of Health Policy and Management, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, 100730, People’s Republic of China
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Mallat A, Vrontis D, Thrassou A. Patient satisfaction in the context of public–private partnerships. INTERNATIONAL JOURNAL OF ORGANIZATIONAL ANALYSIS 2020. [DOI: 10.1108/ijoa-03-2020-2066] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Purpose
This study aims to provide insights into the public–private partnerships (PPP) concept and its performance measurement in the health-care sector, identifying and refining critical success factors, including the perceived quality of health care, as evidenced by patient satisfaction and policy requirements for successful PPP implementation.
Design/methodology/approach
This theoretical study explores the existing literature on the relationship between service quality and patient satisfaction, to propose a culture-specific conceptual model interlinking the drivers of patient satisfaction with PPP. The in-depth theoretical research focuses on the qualitative performance indicators of PPPs, as well as their corresponding peripheral factors.
Findings
The research presents theoretical evidence that the concept of patient satisfaction can only be viewed through a multifactor perspective that incorporates demographics of patients, perceived service quality factors and emotions. It is found that significant improvements in service quality and patient satisfaction do, indeed, emphasize the effective role of PPP in hospitals.
Practical implications
The theoretical model is based on a comprehensive set of both cognitive and affective determinants. And considering these, as well as their causes, effects and interrelations, sets the foundations for testing and for further research to develop. Moreover, the outcomes of this study can be used as a theoretical base for the development of a PPP qualitative performance measurement framework.
Originality/value
This study attempts to fill the gap in knowledge on service quality and patient satisfaction as qualitative indicators for hospital performance after and toward PPP, while setting explicit factors and opening clear research avenues for further studies to follow.
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Bashir S, Nasir M. Tradeoff between efficiency and perceived quality: evidence from patient-level data. Int J Qual Health Care 2020; 32:591-598. [DOI: 10.1093/intqhc/mzaa098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Revised: 07/29/2020] [Accepted: 08/18/2020] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objectives
To estimate technical efficiency scores of District Headquarter Hospitals (DHQHs) for obstetric services and to explore the relationship between the efficiency of DHQHs and the patients’ satisfaction about the quality of services provided.
Design, Setting and Participants
Data from Health Facility Assessment (HFA) survey is used for efficiency measurement. The data on patient’s perceptions and other control variables are taken from Client Exit Interviews part of the HFA survey. Two-stage residual inclusion, Ordered Logistic Regression and Least square dummy variable techniques are used to investigate the relationship between technical efficiency and patients’ satisfaction level.
Main Outcome Measure(s) and Results
The average efficiency score for Pakistan’s DHQHs is 0.52, and not a single hospital is fully efficient. Moreover, the relationship between technical efficiency and patients’ satisfaction is found to be negative and statistically significant indicating that an increase in hospital efficiency tends to decrease patients’ satisfaction. The disaggregated analysis reveals that patients’ satisfaction associated with the healthcare provider attitude and communication is more affected by technical efficiency.
Conclusion
Patients’ satisfaction level is more sensitive to physician’s attitude and communication. This makes sense because the longer the consultation time, the more accurate the diagnosis would be. This, together with a comforting and confident physician, is likely to achieve better patients’ satisfaction.
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Affiliation(s)
- Saima Bashir
- Pakistan Institute of Development Economics Quaid-i-Azam University Campus, Islamabad 44000, Pakistan
| | - Muhammad Nasir
- Pakistan Institute of Development Economics Quaid-i-Azam University Campus, Islamabad 44000, Pakistan
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Hockman L, Bailey J, Sanders J, Muzzey C, Wakefield M, Christensen A, Murray K. A Qualitative Assessment of Patient Satisfaction with Radical Cystectomy for Bladder Cancer at a Single Institution: How Can We Improve? Res Rep Urol 2020; 12:447-453. [PMID: 33117744 PMCID: PMC7550214 DOI: 10.2147/rru.s269405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 08/29/2020] [Indexed: 11/23/2022] Open
Abstract
PURPOSE To evaluate patient satisfaction (with emphasis on preoperative education) with radical cystectomy for bladder cancer at our institution, the University of Missouri Hospital, qualitatively in order to identify specific areas where improvements can be made. MATERIALS AND METHODS We developed a patient survey that used open-ended questions to identify positive and negative experiences that contributed to patient satisfaction. We administered the survey to radical cystectomy patients who met inclusion criteria and agreed to participate. We recorded, transcribed and qualitatively coded the responses. We identified four themes under which both positive and negative responses were placed, and constructed two diagrams to better illustrate contributors to patient experience and satisfaction. RESULTS We identified 25 patients who met inclusion criteria. Of those, 13 participated in the survey. Regarding overall experience, 92.3% of patients rated their care as excellent or good. Regarding preoperative education, 76.9% of patients reported they definitely or somewhat received enough information on what to expect after surgery, and 76.9% definitely received enough guidance on how to care for themselves after surgery. From qualitative coding of patient responses to open-ended questions, we identified preoperative preparation, delivery of care, caregiver availability, and patient-centered care as themes that contributed positively and negatively to patient experience. CONCLUSION Although the overall patient satisfaction could be perceived as high (92.3%), qualitative analysis revealed several areas where improvements can be made to improve patient experience with radical cystectomy at our institution. As previously expected, preoperative preparation was a contributor.
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Affiliation(s)
- Lukas Hockman
- Division of Urology, Department of Surgery, School of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Jacob Bailey
- Division of Urology, Department of Surgery, School of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Jacob Sanders
- Division of Urology, Department of Surgery, School of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Catherine Muzzey
- Division of Urology, Department of Surgery, School of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Mark Wakefield
- Division of Urology, Department of Surgery, School of Medicine, University of Missouri, Columbia, Missouri, USA
| | - Amy Christensen
- Department of Health Management and Informatics, University of Missouri, Columbia, Missouri, USA
| | - Katie Murray
- Division of Urology, Department of Surgery, School of Medicine, University of Missouri, Columbia, Missouri, USA
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Taneja U. Brand image to loyalty through perceived service quality and patient satisfaction: A conceptual framework. Health Serv Manage Res 2020; 34:250-257. [PMID: 32996357 DOI: 10.1177/0951484820962303] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Brand image (BI) is a relatively new concept in the healthcare sector and its value is important for healthcare organizations to survive in this competitive era. Extant research in academics shows the diversity in determinants of patient satisfaction (PS), perceived service quality (PSQ), loyalty and brand image (BI) in the healthcare sector. The large numbers of existing studies mainly emphasize constructs such as PS, PSQ or the relationship between these two, taking into consideration other factors like cost and loyalty. The purpose of this study is to systematically review and summarize current research as well as propose a conceptual model of hospital brand image and its impact on patient loyalty through PSQ and PS. We provide a research framework for future theoretical and empirical studies on the impact of BI on patient loyalty.
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Affiliation(s)
- Udita Taneja
- University School of Management Studies, Guru Gobind Singh Indraprastha University, New Delhi, India
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Vimla, Taneja U. Navigating from Brand Image to Patient Loyalty: Mediating Effect of Service Quality and Patient Satisfaction. JOURNAL OF HEALTH MANAGEMENT 2020. [DOI: 10.1177/0972063420937940] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose: This study aims to analyse brand image (BI)–service quality (SQ)–patient satisfaction (PS)–loyalty in healthcare by understanding BI and SQ modelled as multidimensional constructs in Indian healthcare. Furthermore, the mediating effect from BI to loyalty through SQ and PS is examined. Design/methodology/approach: Analysis of survey data of 210 patients from Indian hospitals reveals that BI directly affects SQ, PS and loyalty, that SQ directly influences PS, that PS directly influences loyalty of patients and that PS and BI are significant determinants of loyalty. Findings: Our findings suggest that BI has both a direct and indirect (through SQ and PS) impact on loyalty of patients. Moreover, the mediation of BI to loyalty through SQ and PS is partial and complementary mediation. Practical implications: By understanding the relationship between BI, SQ, PS and loyalty, managers will be able to better understand the mechanism to enhance loyalty. As BI impacts loyalty indirectly through SQ and PS, managers need to improve quality, which will enhance satisfaction of patients and thus help in the formation of loyal patients. Originality/value: This study shows how the mediating effect of SQ and PS can be used to improve patient loyalty by building positive BI.
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Affiliation(s)
- Vimla
- University School of Management Studies, GGS Indraprastha University, Dwarka, New Delhi, India
| | - Udita Taneja
- University School of Management Studies, GGS Indraprastha University, Dwarka, New Delhi, India
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Tavares AI, Ferreira PL. Public satisfaction with health system coverage, empirical evidence from SHARE data. INTERNATIONAL JOURNAL OF HEALTH ECONOMICS AND MANAGEMENT 2020; 20:229-249. [PMID: 32060666 DOI: 10.1007/s10754-020-09279-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 02/10/2020] [Indexed: 06/10/2023]
Abstract
People's satisfaction with the health system, including the coverage provided, has been a concern for some years now but research into the main explanatory factors is in progress. This work focuses on European countries plus Israel, using the SHARE database to find what determines people's satisfaction with the basic coverage provided by the health system of each country. On top of the usual individual socioeconomic characteristics, other explanatory factors were also considered. These include, at individual level, trust in others, political positioning, and risk aversion; at country level, they include access to specialist care and the type of health system financing. Estimation of an ordered logistic model found that the main predictors for satisfaction with a health system's basic coverage include trust in others, unmet health needs, self-assessed health, free access to specialists, health system financed through social insurance, and out-of-pocket payments. These results provide the basis for possible policies designed to improve people's satisfaction.
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Affiliation(s)
- Aida Isabel Tavares
- CEISUC, Centre of Research in Health of the University of Coimbra, Av. Dias da Silva, 65, Coimbra, Portugal.
- ISEG, Lisbon School of Economics and Management, University of Lisbon, Rua do Quelhas, 6, Lisboa, Portugal.
- FEUC, Faculdade de Economia da, Universidade de Coimbra, Av. Dias da Silva, 65, Coimbra, Portugal.
| | - Pedro Lopes Ferreira
- CEISUC, Centre of Research in Health of the University of Coimbra, Av. Dias da Silva, 65, Coimbra, Portugal
- FEUC, Faculdade de Economia da, Universidade de Coimbra, Av. Dias da Silva, 65, Coimbra, Portugal
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A comparative study of patients' satisfaction with different levels of hospitals in Beijing: why do patients prefer high-level hospitals? BMC Health Serv Res 2020; 20:643. [PMID: 32650761 PMCID: PMC7350561 DOI: 10.1186/s12913-020-05507-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Accepted: 07/03/2020] [Indexed: 12/28/2022] Open
Abstract
Background To promote the integration of medical resources, Beijing has built medical alliances since 2012, but this reform has not changed the state of disordered medical treatment. Patients are still willing to go to high-level hospitals for medical treatment. What causes patients to prefer high-level hospitals? To explore the reasons behind this preference for high-level medical treatment among patients and to guide patients to make visits in an orderly manner, we conducted this study and compared patients’ satisfaction with hospitals of different levels in the context of medical resource integration. Methods This study conducted a questionnaire survey among 1250 patients who were selected in 18 medical alliances in Beijing from October to December 2016. The study type is a comparative study based on cross-sectional data. Patient satisfaction was the main outcome, and descriptive analysis, chi-square tests, nonparametric tests and binary logistic regression analysis were used. The level of statistical significance was set at p < 0.05. Results The overall satisfaction score of the medical alliances was 3.375, and the satisfaction scores of core hospitals and cooperative hospitals were 2.77 and 3.07, respectively. The overall patient satisfaction rate was 44.62%, and the satisfaction rates of core hospitals and cooperative hospitals were 34.34 and 50.43%, respectively. The type of hospital and understanding of medical alliance policy were the factors associated with patient satisfaction with the medical alliance. Conclusions The patients’ satisfaction with cooperative hospitals was higher than their satisfaction with core hospitals. Although the patients were more satisfied with the service attitude of the cooperative hospitals, they still preferred core hospitals due to their higher expectations for their medical treatment and greater trust in their medical technology. It is necessary to explore the establishment of closed medical alliances under the unified management of human and financial resources to enable medical alliances to become a community of common interests and provide integrated medical services for patients.
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Witzeman K, Antunez Flores O, Renzelli-Cain RI, Worly B, Moulder JK, Carrillo JF, Schneider B. Patient-Physician Interactions Regarding Dyspareunia with Endometriosis: Online Survey Results. J Pain Res 2020; 13:1579-1589. [PMID: 32636669 PMCID: PMC7334010 DOI: 10.2147/jpr.s248887] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Accepted: 04/28/2020] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Dyspareunia can be a debilitating symptom of endometriosis. We performed this study to examine women's experiences with painful sexual intercourse, the impact of dyspareunia on patients' lives, and perceptions of interactions with healthcare practitioners. METHODS An anonymous 24-question online survey was provided through the social media network MyEndometriosisTeam.com and was available internationally to women aged 19-55 years who were self-identified as having endometriosis and had painful sexual intercourse within the past 2 years. RESULTS From June 13 to August 20, 2018, 860 women responded and 638 women completed the survey (United States, n = 361; other countries, n = 277; 74% survey completion rate). Respondents reported high pain levels (mean score, 7.4 ± 1.86; severity scale of 0 [no pain] to 10 [worst imaginable pain]), with 50% reporting severe pain [score of 8 to 10]). Nearly half (47%) reported pain lasting ≥24 hours after intercourse with the pain often leading to avoiding (34%) or stopping (29%) intercourse. Pain impacted patients' lives, causing depression (61%), anxiety (61%), low self-esteem (55%), and relationship strain. Many women feared to seek help (10%). Of those women who approached practitioners, many (36%) did not receive effective treatments. DISCUSSION Women with dyspareunia related to endometriosis experience severe pain that can negatively impact patients' lives. Dyspareunia may be a challenging topic for discussion for both patient and practitioner, leading to a suboptimal treatment approach and management. Results suggest that practitioners need improved education and training regarding dyspareunia to evaluate and treat patients' sexual pain caused by endometriosis.
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Affiliation(s)
- Kathryn Witzeman
- Department of Obstetrics and Gynecology, Denver Health Medical Center, Denver, CO, USA
| | | | | | - Brett Worly
- Department of Obstetrics and Gynecology, The Ohio State University, Columbus, OH, USA
| | - Janelle K Moulder
- Department of Obstetrics and Gynecology, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jorge F Carrillo
- Department of Obstetrics and Gynecology, University of Central Florida, Orlando, FL, USA
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Nguyen ATB, Nguyen NTK, Phan PH, van Eeuwijk P, Fink G. Parental satisfaction with quality of neonatal care in different level hospitals: evidence from Vietnam. BMC Health Serv Res 2020; 20:238. [PMID: 32192485 PMCID: PMC7082960 DOI: 10.1186/s12913-020-5070-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2019] [Accepted: 03/04/2020] [Indexed: 11/10/2022] Open
Abstract
Background Most health systems provide the most specialized, and presumably also the highest quality of care at a central level. This study assessed parental satisfaction and its determinants in the context of neonatal care in a provincial as well as a national hospital of Vietnam. Methods In this cross-sectional quantitative study, parents of 340 preterm infants admitted to neonatal care units of a national and a provincial hospital in 2018 were interviewed using structured questionnaires. Unadjusted and adjusted linear regression models were used to assess the relationship between parental satisfaction and hospital rank. Results The mean parental satisfaction score was 3.74 at the provincial, and 3.56 at the national hospital. These satisfaction differences persisted when parent and child characteristics were adjusted for in multivariate analysis. Longer length of stay and worsening infant health status were associated with parents reporting lower levels of satisfaction with the quality of care being provided at the healthcare facility. Conclusions This study suggests that parents of preterm infants admitted in a provincial hospital were more satisfied with the quality of care received than those in a specialized national hospital. Length of stay and infant health status were the two most important determinants of level of parental satisfaction.
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Affiliation(s)
- An Thi Binh Nguyen
- Swiss Tropical and Public Health Institute, Basel, Switzerland. .,University of Basel, Basel, Switzerland.
| | | | - Phuc Huu Phan
- Vietnam National Children's Hospital, Hanoi, Vietnam
| | - Peter van Eeuwijk
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland.,Institute of Social Anthropology, Basel, Switzerland
| | - Günther Fink
- Swiss Tropical and Public Health Institute, Basel, Switzerland.,University of Basel, Basel, Switzerland
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Schutt RK, Woodford ML. Increasing health service access by expanding disease coverage and adding patient navigation: challenges for patient satisfaction. BMC Health Serv Res 2020; 20:175. [PMID: 32143726 PMCID: PMC7059366 DOI: 10.1186/s12913-020-5009-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2019] [Accepted: 02/18/2020] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Cancer control programs have added patient navigation to improve effectiveness in underserved populations, but research has yielded mixed results about their impact on patient satisfaction. This study focuses on three related research questions in a U.S. state cancer screening program before and after a redesign that added patient navigators and services for chronic illness: Did patient diversity increase; Did satisfaction levels improve; Did socioeconomic characteristics or perceived barriers explain improved satisfaction. METHODS Representative statewide patient samples were surveyed by phone both before and after the program design. Measures included satisfaction with overall health care and specific services, as well as experience of eleven barriers to accessing health care and self-reported health and sociodemographic characteristics. Multiple regression analysis is used to identify independent effects. RESULTS After the program redesign, the percentage of Hispanic and African American patients increased by more than 200% and satisfaction with overall health care quality rose significantly, but satisfaction with the program and with primary program staff declined. Sociodemographic characteristics explained the apparent program effects on overall satisfaction, but perceived barriers did not. Further analysis indicates that patients being seen for cancer risk were more satisfied if they had a patient navigator. CONCLUSIONS Health care access can be improved and patient diversity increased in public health programs by adding patient navigators and delivering more holistic care. Effects on patient satisfaction vary with patient health needs, with those being seen for chronic illness likely to be less satisfied with their health care than those being seen for cancer risk. It is important to use appropriate comparison groups when evaluating the effect of program changes on patient satisfaction and to consider establishing appropriate satisfaction benchmarks for patients being seen for chronic illness.
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Affiliation(s)
- Russell K Schutt
- Department of Sociology, University of Massachusetts Boston and Harvard Medical School, Boston, MA, 02125-3393, USA.
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Lamvu G, Antunez-Flores O, Orady M, Schneider B. Path to diagnosis and women’s perspectives on the impact of endometriosis pain. JOURNAL OF ENDOMETRIOSIS AND PELVIC PAIN DISORDERS 2020. [DOI: 10.1177/2284026520903214] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction: Endometriosis is a burdensome chronic disease that can be difficult to diagnose, yet few studies examine experiences along the continuum of disease state. We sought to explore women’s journeys to an endometriosis diagnosis, experience with endometriosis pain, and interactions with healthcare practitioners. Methods: An anonymous 23-question online survey was distributed to women (aged >19 years) who self-identified as having a surgical or nonsurgical diagnosis of endometriosis and living in seven English-speaking countries through the social media network MyEndometriosisTeam.com . Results: From January through April 2018, 317 women in the United States and 134 women outside the United States completed the survey. More than 50% of the women waited 6 or more years for a diagnosis of endometriosis. Overall, 54.3% experienced endometriosis-related pain daily. Respondents (US/non-US) reported a significant impairment in quality of life that interfered with their family (45.7%/45.5%) and social life (40.1%/44.0%), education/career (42.9%/46.3%), and sexual function (68.1%/70.1%). Women reported their disease led to other conditions, including fatigue (93.6%), gastrointestinal issues (91.8%), and difficulty sleeping (87.4%). Many women were not satisfied with their practitioner’s ability to listen to concerns and felt that their practitioner’s treatment recommendations lacked consistency with their own goals/needs. Conclusion: Women still experience long delays and difficult journeys to an endometriosis diagnosis. Disease-associated pain is pervasive and has direct and indirect impacts on quality of life. Women are frequently not satisfied with disease-management options presented to them by their practitioners. These results suggest a need for improved medical education on disease state for both patients and practitioners.
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Affiliation(s)
- Georgine Lamvu
- Gynecology Division, Department of Surgery, Orlando VA Medical Center, Orlando, FL, USA
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Özhanlı Y, Akyolcu N. Satisfaction of Patients with Triage and Nursing Practice in Emergency Departments. Florence Nightingale Hemsire Derg 2020; 28:49-60. [PMID: 34263185 PMCID: PMC7968468 DOI: 10.5152/fnjn.2020.18041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Accepted: 04/29/2019] [Indexed: 11/22/2022] Open
Abstract
AIM This research was carried out to evaluate the satisfaction of triage and nursing practice for emergency patients. METHOD The sample for this descriptive study comprised 198 patients (115 women and 83 men) that visited the emergency department at an education and research hospital between December 01, 2013, and December 31, 2013, and agreed to participate in the study. The participants had been informed about the purpose, content, and methods of this study. Then, the data collection forms (patient information form, Triage Satisfaction Scale, and Newcastle Satisfaction with Nursing Scale) were administered to the patients. Data analysis involved descriptive statistical methods as well as parametric and nonparametric tests. RESULTS It was determined that the mean age of the patients in the emergency department was 38.56 ± 17.43 years, and 51.5% (n=102) patients were in the yellow triage category. It was determined that a majority of patients did not wait for triage and indicated that they were receiving treatment in accordance with the triage category. The total Triage Satisfaction Scale mean score was 7.37±2.11 and the total Newcastle Satisfaction with Nursing Scale mean score was 73.34±17.66. It was found that there was a significant difference between the waiting status and satisfaction scores in the triage section of the patients. It was also found that there was a meaningful difference between the dimensions of satisfaction with treatment and care in terms of the triage category. CONCLUSION It was determined that the patients who applied to the emergency unit were generally satisfied by the triage practice and nursing care. The nursing care satisfaction levels of the patient and their family regarding the health status and psychological support were found to be low. It may be advisable to periodically implement satisfaction analyses of the nursing practices in such units in order to make necessary arrangements and to eliminate deficiencies.
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Affiliation(s)
- Yasemin Özhanlı
- Department of Surgical Nursing, İstanbul University-Cerrahpaşa Florence Nightingale Faculty of Nursing, İstanbul, Turkey
| | - Neriman Akyolcu
- Department of Nursing, İstanbul İstinye University, Faculty of Health Sciences, İstanbul, Turkey
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Otani K, Deng Y, Herrmann PA, Kurz RS. Patient Satisfaction, Quality Attributes, and Organizational Characteristics: A Hierarchical Linear Model Approach. J Patient Exp 2019; 7:801-806. [PMID: 33294618 PMCID: PMC7705829 DOI: 10.1177/2374373519892410] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Patient satisfaction studies have gained more and more attention, and there are many patient satisfaction studies. These studies assume that patients were selected randomly and independently, but patient satisfaction surveys are described as a multistage or hierarchically structured sample. Thus, there is a need to conduct a hierarchical linear model (HLM) analysis with a large number of hospitals. This study utilized an HLM to investigate both the individual patient-level effect on the overall satisfaction rating and the effect of hospital characteristics on the combining process of patient’s overall satisfaction rating. This study used patient satisfaction data collected from 100 hospitals with the sample size of 85 766. The hospital-level characteristics include total expense per personnel, payroll expense per personnel, number of staffed beds per personnel, and number of admission per personnel. This study found that hospital characteristics influence overall rating of the hospital through the doctor, staff, and room attributes. When considering the complex nature of the overall patient rating process of hospitals, it makes more sense to analyze hospital characteristics that are interacting with attributes rather than treat hospital characteristics as independent of these factors.
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Affiliation(s)
- Koichiro Otani
- Department of Public Policy, Purdue University Fort Wayne, Fort Wayne, IN, USA
| | - Yihao Deng
- Department of Mathematical Sciences, Purdue University Fort Wayne, Fort Wayne, IN, USA
| | | | - Richard S Kurz
- School of Public Health, University of North Texas, Fort Worth, TX, USA
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Hu L, Zhou BP, Liu S, Wang Z, Liu Y. Outpatient Satisfaction with Tertiary Hospitals in China: The Role of Sociodemographic Characteristics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16193518. [PMID: 31547189 PMCID: PMC6801474 DOI: 10.3390/ijerph16193518] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Revised: 09/13/2019] [Accepted: 09/18/2019] [Indexed: 12/16/2022]
Abstract
China’s increasing attention to patient satisfaction evaluation is part of an international trend of patient-centered healthcare. Patient sociodemographic characteristics are important intrinsic factors that will influence satisfaction. This paper aims to better understand how sociodemographic factors affect Chinese patient satisfaction with tertiary outpatient services using data from the 2017 China National Patient Survey. A total of 28,760 outpatient survey responses were analyzed, spanning 136 tertiary hospitals across 31 provinces. Multilevel logistic regression with fixed hospital effects was used to examine the association of patient satisfaction across multiple healthcare domains with sociodemographic factors. Results show that patients who were of a migrant population, of highest income, most educated, and who had medical aid insurance reported the lowest levels of overall satisfaction. Specifically, increasing age was correlated with decreased satisfaction in process management and affordability domains, while high-income and high-education outpatients reported lower satisfaction scores in the hospital environment domain. Furthermore, migrant patients experienced lower satisfaction across several domains. These intricate findings suggest that hospitals should tailor their services and evaluation metrics to specific patient demographics, and that the government should adopt policies that reduce disparities in healthcare access and affordability to ultimately improve the satisfaction of vulnerable groups.
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Affiliation(s)
- Linlin Hu
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China.
| | - Bright P Zhou
- Stanford University School of Medicine, 291 Campus Drive, Stanford, CA 94305, USA.
| | - Shiyang Liu
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China.
| | - Zijuan Wang
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China.
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, 5 Dongdansantiao, Dongcheng District, Beijing 100730, China.
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Custer MG, Huebner RA. Identifying Homogeneous Outcome Groups in Adult Rehabilitation Using Cluster Analysis. Am J Occup Ther 2019; 73:7305205050p1-7305205050p9. [PMID: 31484029 DOI: 10.5014/ajot.2019.031997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
IMPORTANCE Adults receiving occupational therapy in inpatient rehabilitation are a heterogeneous population with differing needs, outcomes, and rehabilitation processes. Outcome studies based on what works for all clients may obscure the needs of population subgroups who benefit unequally from rehabilitation services. OBJECTIVE To identify subgroups on the basis of client satisfaction and progress in functional self-care among a diverse rehabilitation population and to understand subgroup differences in occupational therapy and rehabilitation processes and client discharge status. DESIGN Using an existing dataset, we used K-means cluster analysis of demographics, status at admission, and the outcomes of satisfaction and change in self-care to identify five homogeneous outcome groups. Occupational therapy and rehabilitation processes and discharge status were compared across subgroups. SETTING Inpatient rehabilitation hospital. PARTICIPANTS The dataset included 1,099 inpatients age 18 yr and older who received occupational therapy over a 27-mo period. MEASURES Admission measures included the Inpatient Rehabilitation Facility-Patient Assessment Instrument and self-care items of the FIM™. The Satisfaction with Continuum of Care-Revised was administered after discharge. RESULTS Five subgroups showed statistically different patterns of medical complications, functional self-care, rates of progress, satisfaction with intervention, and course of treatment. The profile of each group suggests differing therapeutic needs. Although all groups made significant gains in functional self-care, two groups continued to need physical assistance at discharge. CONCLUSION and Relevance: Cluster analysis proved useful in segmenting a typical heterogeneous rehabilitation population into more homogeneous subgroups to enhance understanding of clinical needs and to potentially increase the potency of outcomes research. WHAT THIS ARTICLE ADDS This research identified subgroups within a typical population of rehabilitation clients receiving occupational therapy and identified their unique needs and outcomes using cluster analysis techniques.
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Affiliation(s)
- Melba G Custer
- Melba G. Custer, PhD, OT/L, is Professor, Auerbach School of Occupational Therapy, Spalding University, Louisville, KY;
| | - Ruth A Huebner
- Ruth A. Huebner, PhD, OTR, FAOTA, is Retired Professor, Eastern Kentucky University, Richmond
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Mocumbi S, Högberg U, Lampa E, Sacoor C, Valá A, Bergström A, von Dadelszen P, Munguambe K, Hanson C, Sevene E. Mothers' satisfaction with care during facility-based childbirth: a cross-sectional survey in southern Mozambique. BMC Pregnancy Childbirth 2019; 19:303. [PMID: 31426758 PMCID: PMC6701029 DOI: 10.1186/s12884-019-2449-6] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 08/06/2019] [Indexed: 11/23/2022] Open
Abstract
Background Client satisfaction is an essential component of quality of care. Health system factors, processes of care as well as mothers’ characteristics influence the extent to which care meets the expectations of mothers and families. In our study, we specifically aimed to address the mothers’ experiences of, and satisfaction with, care during childbirth. Methods A population-based cross-sectional study, using structured interviews with published sequences of questions assessing satisfaction, including 4358 mothers who gave birth during the 12 months before June 2016 to estimate satisfaction with childbirth care. Regression analysis was used to determine the predictors of client satisfaction. Results Most mothers (92.5%) reported being satisfied with care during childbirth and would recommend that a family member to deliver at the same facility. Specifically, 94.7% were satisfied with the cleanliness of the facility, 92.0% reported being satisfied with the interaction with the healthcare providers, but only 49.8% felt satisfied with the assistance to feed their baby. Mothers who had negative experiences during the process of care, such as being abandoned when needing help, disrespect, humiliation, or physical abuse, reported low levels of satisfaction when compared to those who had not had such experiences (68.5% vs 93.5%). Additionally, they reported higher levels of dissatisfaction (20.1% vs 2.1%). Regression analysis revealed that mothers who gave birth in primary level facilities tended to be more satisfied than those who gave birth in hospitals, and having a companion increased, on average, the overall satisfaction score, with 0.06 in type II health centres (CI 0.03–0.10) and with 0.05 in type I health centres (CI − 0.02 – 0.13), compared to − 0.01(CI -0.08 – 0.07) in the hospitals, irrespective of age, education and socio-economic background. Conclusion Childbirth at the primary level facilities contributes to the level of satisfaction. The provision of childbirth care should consider women’s preferences and needs, including having a companion of choice. We highlight the challenge in balancing safety of care versus satisfaction with care and in developing policies on the optimum configuration of childbirth care. Interventions to improve the interaction with providers and the provision of respectful care are recommended. Electronic supplementary material The online version of this article (10.1186/s12884-019-2449-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Sibone Mocumbi
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universidade Eduardo Mondlane (UEM), Av. Salvador Allende 702, 1100, Maputo, Mozambique. .,Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden.
| | - Ulf Högberg
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden
| | - Erik Lampa
- Uppsala Clinical Research Centre, Uppsala University, Dag Hammarskjölds väg 38, 751 85, Uppsala, Sweden
| | - Charfudin Sacoor
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique
| | - Anifa Valá
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique
| | - Anna Bergström
- Department of Women's and Children's Health, Uppsala University, Akademiska sjukhuset, SE-75185, Uppsala, Sweden.,University College London, Institute for Global Health, Gower St, London, WC1E 6BT, UK
| | - Peter von Dadelszen
- Department of Women and Children's Health, School of Life Course Sciences, Faculty of Life Sciences and Medicine, King's College London, 1 Lambeth Palace Road, London, SE1 7EU, UK
| | - Khátia Munguambe
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique.,Department of Public Health, Faculty of Medicine, Universidade Eduardo Mondlane, Av. Salvador Allende 702 R/C, Maputo, Mozambique
| | - Claudia Hanson
- Department of Public Health Sciences, Karolinska Institutet, Tomtebodavagen 18A, Plan 4, Stockholm, Sweden.,Department of Disease Control, London School of Hygiene and Tropical Medicine, Keppel St, London, WC1E 7HT, UK
| | - Esperança Sevene
- Centro de Investigação em Saúde de Manhiça (CISM), Rua 12, Manhiça, Mozambique.,Department of Physiological Science, Clinical Pharmacology, Faculty of Medicine, Universidade Eduardo Mondlane, Av. Salvador Allende 702 R/C, Maputo, Mozambique
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