1
|
Tse MP, Dhalla I, Nayyar D. Google star ratings of Canadian hospitals: a nationwide cross-sectional analysis. BMJ Open Qual 2024; 13:e002713. [PMID: 39038856 DOI: 10.1136/bmjoq-2023-002713] [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: 12/11/2023] [Accepted: 06/29/2024] [Indexed: 07/24/2024] Open
Abstract
BACKGROUND Data on patients' self-reported hospital experience can help guide quality improvement. Traditional patient survey programmes are resource intensive, and results are not always publicly accessible. Unsolicited online hospital reviews are an alternative data source; however, the nature of online reviews for Canadian hospitals is unknown. METHODS We conducted a nationwide cross-sectional study of Canadian acute care hospitals with more than 10 Google Reviews during the 2018-2019 fiscal year. We characterised the volume and distribution of Google Reviews of Canadian hospitals, and assessed their correlation with hospital characteristics (teaching status, size, occupancy rate, length of stay, resource utilisation) and Canadian Patient Experience Survey on Inpatient Care (CPES-IC) scores. RESULTS 167 out of 523 (31.9%) acute care hospitals in Canada met the inclusion criteria. Among included hospitals, there was a total of 10 395 Google Reviews and a median of 35 reviews per hospital. The mean Google Star Rating for included hospitals was 2.85 out of 5, with a range of 1.36-4.57. Teaching hospitals had significantly higher mean Google Star Ratings compared with non-teaching hospitals (3.16 vs 2.81, p <0.01). There was a weak, positive correlation between hospitals' Google Star Ratings and CPES-IC 'Overall Hospital Experience' scores (p =0.04), but no significant correlation between Google Star Ratings and other hospital characteristics or subcategories of CPES-IC scores. INTERPRETATION There is significant interhospital variation in patients' self-reported care experiences at Canadian acute care hospitals. Online reviews can serve as a readily accessible source of real-time data for hospitals to monitor and improve the patient experience.
Collapse
Affiliation(s)
| | - Irfan Dhalla
- Unity Health Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Dhruv Nayyar
- Unity Health Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|
2
|
Beckett MK, Quigley DD, Lehrman WG, Giordano LA, Cohea CW, Goldstein EH, Elliott MN. Interventions and Hospital Characteristics Associated With Patient Experience: An Update of the Evidence. Med Care Res Rev 2024; 81:195-208. [PMID: 38238918 DOI: 10.1177/10775587231223292] [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: 05/15/2024]
Abstract
Patient experience is a key hospital quality measure. We review and characterize the literature on interventions, care and management processes, and structural characteristics associated with better inpatient experiences as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey. Prior reviews identified several promising interventions. We update these previous efforts by including more recent peer-reviewed literature and expanding the review's scope to include observational studies of HCAHPS measures with process measures and structural characteristics. We used PubMed to identify U.S. English-language peer-reviewed articles published in 2017 to 2020 and focused on hospital patient experience. The two HCAHPS domains for which we found the fewest potential quality improvement interventions were Communication with Doctors and Quietness. We identified several modifiable processes that could be rigorously evaluated in the future, including electronic health record patient engagement functionality, care management processes, and nurse-to-patient ratios. We describe implications for future policy, practice, and research.
Collapse
|
3
|
Li Z, Ho V, Merrell MA, Hung P. Trends in patient perceptions of care toward rural and urban hospitals in the United States: 2014-2019. J Rural Health 2024; 40:565-573. [PMID: 38031505 DOI: 10.1111/jrh.12813] [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: 06/18/2023] [Revised: 10/26/2023] [Accepted: 11/16/2023] [Indexed: 12/01/2023]
Abstract
PURPOSE Understanding rural-urban disparities in patient satisfaction is critical to identify gaps for improvement in patient-centered care and tailor interventions to specific patient needs, especially those in the Frontier and Remote areas (FAR). This study aimed to examine disparities in patient perceptions of care between urban, rural non-FAR, and FAR hospitals between 2014 and 2019. METHODS This is a retrospective longitudinal study using 2014-2019 Hospital Consumer Assessment of Healthcare Providers and Systems data linked to American Hospital Annual Survey data (3,524 hospitals in 2014 and 3,440 hospitals in 2019). Multivariable linear regression models were used to identify differential trends in patient perceptions of care by hospital rurality over 2014-2019, adjusting hospital- and county-level characteristics. FINDINGS In 2014, patients at rural non-FAR and FAR hospitals had lower percentages of willingness to definitely recommend these hospitals than urban hospitals (average percentage difference, 95% CI: -4.0% [-4.5%, -3.5%]; -2.0% [-2.8%, -1.2%]); yet, over the study period, rural hospitals experienced steeper increases in patient willingness to recommend (0.2% [0.07%, 0.4%]; 0.4% [0.08%, 0.7%]). FAR hospitals also showed improvements in patient experience in a clean environment, communication with nurses, communication about medicines, and responsiveness of staff. Communication with doctors showed slight decreases across hospital locations. CONCLUSIONS Patient perceptions of care were generally improved in all US hospitals from 2014 to 2019, except communications with doctors. These findings highlight the potential for enhancing patient satisfaction and experience in urban hospitals and suggest the need to improve patient willingness to recommend in rural FAR hospitals.
Collapse
Affiliation(s)
- Zhong Li
- School of Health Policy and Management, Nanjing Medical University, Nanjing, China
- Rural & Minority Health Research Center, University of South Carolina, Columbia, South Carolina, USA
| | - Vivian Ho
- Rural & Minority Health Research Center, University of South Carolina, Columbia, South Carolina, USA
| | - Melinda A Merrell
- Rural & Minority Health Research Center, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Peiyin Hung
- Rural & Minority Health Research Center, University of South Carolina, Columbia, South Carolina, USA
- Department of Health Services Policy and Management, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| |
Collapse
|
4
|
Crooks E, Rampley T, Weeks DL, Billings C, Stengem D, Rangel T. Perceived Barriers to Patient Mobilization Among Therapy and Nursing Acute Care Staff: A Multi-Site Survey Study. Arch Phys Med Rehabil 2024; 105:243-250. [PMID: 37429536 DOI: 10.1016/j.apmr.2023.06.018] [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: 04/17/2023] [Revised: 06/24/2023] [Accepted: 06/27/2023] [Indexed: 07/12/2023]
Abstract
OBJECTIVE To identify differences in perceived barriers to patient mobilization in acute care among therapy and nursing clinicians, and among hospitals of different sizes and types. DESIGN Cross-sectional survey study. SETTING Eight hospitals of various sizes and types (teaching vs non-teaching; urban vs rural), from 2 different states in the Western region of the United States. PARTICIPANTS A nonprobability sample of 568 acute care clinicians (N=586) involved in direct patient care were surveyed. Clinicians indicated a clinical role within the branch of therapy (physical therapy or occupational therapy) or nursing (registered nurse or nurse assistant). MAIN OUTCOME MEASURES The Patient Mobilization Attitudes and Beliefs Survey (PMABS) was used to assess perceived barriers to early patient mobilization among therapy and nursing staff. A PMABS total score and 3 subscale scores (knowledge, attitudes, or behaviors associated with barriers to mobilization) were calculated, with higher scores indicative of greater mobilization barriers. RESULTS Mean PMABS total scores were significantly lower (better) for therapy providers (24.63±6.67) than nursing providers (38.12±10.95), P<.001. Additionally, therapy providers had significantly lower scores than nursing providers on all 3 subscales (all P<.001). Item-specific analyses revealed significant differences in responses between therapy and nursing staff on 22 of 25 items, with nursing staff indicating greater perceptions of barriers than therapy staff on 20 of the 22 items. The top 5 items with the largest response differences between therapy and nursing clinicians included adequate time to mobilize patients, understanding appropriate referral to therapy staff, knowledge on when it is safe to mobilize patients, confidence in the ability to mobilize patients, and receiving training on methods of safe mobilization. While hospital type did not affect perceived barriers to early mobilization, PMABS scores were significantly higher for large and small hospitals when compared to medium-sized hospitals. CONCLUSION Perceived barriers to patient mobilization exist among therapy and nursing acute care clinicians, with greater barriers noted among nursing staff for knowledge, attitudes, and behaviors associated with patient mobility practices. Findings suggest future work is warranted, with opportunities for therapy providers to collaborate with nursing providers to address barriers to implementing patient mobility.
Collapse
Affiliation(s)
- Elena Crooks
- Department of Physical Therapy, Eastern Washington University, Spokane, WA.
| | | | - Douglas L Weeks
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA
| | - Crystal Billings
- Nursing Excellence, Providence Swedish, South Puget Sound Region, WA
| | - Danell Stengem
- Nursing Quality & Clinical Education Departments, Providence St. Patrick Hospital, Missoula, MT
| | - Teresa Rangel
- Professional Development Department, Providence Health and Services, Spokane, WA
| |
Collapse
|
5
|
Degabriel D, Petrino R, Frau ED, Uccella L. Factors influencing patients' experience of communication with the medical team of the emergency department. Intern Emerg Med 2023; 18:2045-2051. [PMID: 37142863 PMCID: PMC10543488 DOI: 10.1007/s11739-023-03298-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 04/27/2023] [Indexed: 05/06/2023]
Abstract
The Emergency Department (ED) setting often presents situations where the doctor-patient relationship is fundamental and may be challenging. Thus, it is important to use effective communication to improve outcomes. This study explores patients' experience of communication with the medical team aiming to discover whether there are some objective factors which may affect their perception. A prospective, cross-sectional study in two hospitals: an urban, academic trauma center and a small city hospital. Adult patients discharged from the ED in October 2021 were consecutively included. Patients filled out a validated questionnaire, the Communication Assessment Tool for Teams (CAT-T), assessing communication perception. Additional data about the participants were collected by the physician in a dedicated tab to assess whether there were objective factors influencing the patient's perception of the medical team's communication skills. Statistical analysis was then performed. 394 questionnaires were analyzed. The average score for all items exceeded 4 (good). Younger patients and patients who were conveyed by ambulance attributed lower scores than other groups (p value < 0.05). A significant difference between the two hospitals was also observed in favour of the bigger hospital. In our study long waiting times did not generate less satisfied responses. The item which received the lowest scores was "the medical team encouraged me to ask questions". Overall, patients were satisfied with doctor-patient communication. Age, setting, way of conveyance to the hospital are objective factors that may influence patients' experience and satisfaction in the ED.
Collapse
Affiliation(s)
- Dea Degabriel
- Internal Medicine Department, EOC-Ospedale Regionale di Lugano, via Tesserete 46, 6900, Lugano, Switzerland
| | - Roberta Petrino
- Emergency Department, EOC-Ospedale Regionale di Lugano, via Tesserete 46, 6900, Lugano, Switzerland
| | - Eleonora Dafne Frau
- Emergency Department, EOC-Ospedale Regionale di Lugano, via Tesserete 46, 6900, Lugano, Switzerland
| | - Laura Uccella
- Emergency Department, EOC-Ospedale Regionale di Lugano, via Tesserete 46, 6900, Lugano, Switzerland.
| |
Collapse
|
6
|
Chang J, Medina M, Kim SJ. Is patients' rurality associated with in-hospital sepsis death in US hospitals? Front Public Health 2023; 11:1169209. [PMID: 37383255 PMCID: PMC10294422 DOI: 10.3389/fpubh.2023.1169209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2023] [Accepted: 05/22/2023] [Indexed: 06/30/2023] Open
Abstract
Background The focus of this study was to explore the association of patients' rurality and other patient and hospital-related factors with in-hospital sepsis mortality to identify possible health disparities across United States hospitals. Methods The National Inpatient Sample was used to identify nationwide sepsis patients (n = 1,977,537, weighted n = 9,887,682) from 2016 to 2019. We used multivariate survey logistic regression models to identify predictors for how patients' rurality is associated with in-hospital death. Findings During the study periods, in-hospital death rates among sepsis inpatients continuously decreased (11.3% in 2016 to 9.9% in 2019) for all rurality levels. Rao-Schott Chi-Square tests demonstrated that certain patient and hospital factors had varied in-hospital death rates. Multivariate survey logistic regressions suggested that rural areas, minorities, females, older adults, low-income, and uninsured patients have higher odds of in-hospital mortality. Further, specific census divisions like New England, Middle Atlantic, and East North Central had greater in-hospital sepsis death odds. Conclusion Rurality was associated with increased in-hospital sepsis death across multiple patient populations and locations. Further, rurality in New England, Middle Atlantic, and East North Central locations is exceptionally high odds. In addition, minority races in rural areas also have an increased odds of in-hospital death. Therefore, rural healthcare requires a more significant influx of resources and should also include assessing patient-related factors.
Collapse
Affiliation(s)
- Jongwha Chang
- Department of Pharmaceutical Sciences, Irma Lerma Rangel School of Pharmacy, Texas A&M University, College Station, TX, United States
| | - Mar Medina
- School of Pharmacy, University of Texas at El Paso, El Paso, TX, United States
| | - Sun Jung Kim
- Department of Health Administration and Management, College of Medical Science, Soonchunhyang University, Asan, Republic of Korea
- Center for Healthcare Management Science, Soonchunhyang University, Asan, Republic of Korea
- Department of Software Convergence, Soonchunhyang University, Asan, Republic of Korea
| |
Collapse
|
7
|
Patients Satisfied with Care Report Better Quality of Life and Self-Rated Health-Cross-Sectional Findings Based on Hospital Quality Data. Healthcare (Basel) 2023; 11:healthcare11050775. [PMID: 36900780 PMCID: PMC10001220 DOI: 10.3390/healthcare11050775] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 02/21/2023] [Accepted: 03/03/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Satisfaction with care is an important indicator of health care quality. However, if this process measure is associated with patients' outcomes in real-world data is largely unknown. We, therefore, aimed to evaluate if satisfaction with physician- and nurse-related care is associated with quality of life and self-rated health among inpatients at the University Hospital Hamburg-Eppendorf in Germany. METHOD We used standard hospital quality survey data of 4925 patients treated at various departments. We used multiple linear regressions to examine an association between satisfaction with staff-related care and quality of life as well as self-rated health, adjusted for age, gender, mother tongue, and treating ward. Patients rated their satisfaction with physician- and nurse-related care from 0 "not at all" to 9 "very much". The outcomes regarding quality of life and self-rated health were evaluated on five-point Likert scales ranking from 1 "bad" to 5 "excellent". RESULTS We found that satisfaction with physician-related care was positively associated with quality of life (ß = 0.16; p < 0.001) as well as with self-rated health (ß = 0.16; p < 0.001). Similar findings were observed for satisfaction with nurse-related care and the two outcomes (ß = 0.13; p < 0.001 and ß = 0.14; p < 0.001, respectively). CONCLUSION We show that patients who are more satisfied with staff-related care report better quality of life and self-rated health than patients less satisfied with care. Thus, patient satisfaction with care, is not only a process measure indicating the quality of care but is also positively associated with patient-reported outcomes.
Collapse
|
8
|
Zheng W, Liang Y, Lee WS, Ko Y. The Mediation Effect of Perceived Attitudes toward Medical Service on the Association between Public Satisfaction with the Overall Medical Service and Self-Rated Health among the General Population in China: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3369. [PMID: 36834064 PMCID: PMC9959117 DOI: 10.3390/ijerph20043369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 02/11/2023] [Accepted: 02/13/2023] [Indexed: 06/18/2023]
Abstract
This study aimed to examine the association between public satisfaction with the overall medical service and individuals' self-rated health among 18,852 Chinese adults aged 16-60 years by using data from the 2018 China Family Panel Studies. We further test whether such an association is mediated by perceived attitudes toward the medical service. The logistic regression model is used to explore the association between public satisfaction with the overall medical service and individuals' self-rated health (SRH) outcomes. Mediation analysis was conducted by using the Karlson-Holm-Breen (KHB) method. We found that public satisfaction with the overall medical service was associated with good SRH. Additional results indicated that the association between public satisfaction with the overall medical service and SRH was significantly mediated by perceived attitudes toward the medical service. The degree of mediation is much larger for individuals' satisfaction with the level of medical expertise than for trusting in doctors, attitudes toward medical service problems, and the attitude toward the level of the hospital. Targeted medical policy interventions are designed to promote individuals' perceived attitudes toward the medical service, which might help to improve individuals' health benefits.
Collapse
Affiliation(s)
- Wanwan Zheng
- Graduate School of Management of Technology, Pukyong National University, 365 Sinseon-ro, Nam-gu, Busan 48547, Republic of Korea
| | - Yuqing Liang
- Graduate School of Management of Technology, Pukyong National University, 365 Sinseon-ro, Nam-gu, Busan 48547, Republic of Korea
| | - Woon Seek Lee
- Graduate School of Management of Technology, Pukyong National University, 365 Sinseon-ro, Nam-gu, Busan 48547, Republic of Korea
| | - Youngwook Ko
- Graduate School of Management of Technology, Pukyong National University, 365 Sinseon-ro, Nam-gu, Busan 48547, Republic of Korea
- Institute for Basic Science, Daejeon 34126, Republic of Korea
| |
Collapse
|
9
|
Nurmeksela A, Mikkonen S, Kinnunen J, Kvist T. Validation of the Nurse Managers' Work Content Questionnaire and Factors-A Structural Equation Modeling Study. J Nurs Res 2022; 30:e245. [PMID: 36301852 DOI: 10.1097/jnr.0000000000000526] [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: 11/26/2022] Open
Abstract
BACKGROUND The responsibilities of nurse managers are diverse and occasionally inadequately organized. Moreover, the role of nurse manager often lacks a clear job description. Few methodologies for evaluating the content of nurse managers' work exist. PURPOSE This study was designed to validate the Nurse Managers' Work Content Questionnaire (NMWCQ) instrument and to analyze the relationships between NMWCQ factors and background variables using structural equation modeling. METHODS A multicenter descriptive and cross-sectional study design was used. The NMWCQ, which includes 87 items across 13 components, was developed based on a comprehensive literature review and pilot study. The questionnaire was sent to all of the nurse managers ( N = 756) employed at eight Finnish hospitals in 2019. Exploratory and confirmatory factor analyses were used to psychometrically test and validate the NMWCQ, whereas Cronbach's alpha values were calculated to explore the internal consistency of the instrument. Structural equation modeling was applied to detect the relationships between the constructed factor structure and the background variables. RESULTS Two hundred seven nurse managers participated in this study. The final solution for the NMWCQ included 75 items across 12 factors. The NMWCQ factors were as follows: responsibility for new employees, daily management, human resource management, decision making, clinical nursing, development, planning of processes, collaboration, ensuring knowledge, evidence-based management, ensuring care quality, and financial management. The items showed factor loadings that were either positive or negative, with values ranging from .314 to .846. The Cronbach's alpha values for the factors ranged between .605 and .851. All of the covariances and relationships between background variables and factors were found to be significant ( p ≤ .05). The structural equation modeling showed acceptable index results (incremental fit index = .954, comparative fit index = .951, and root mean square error of approximation = .048). CONCLUSIONS The NMWCQ version assessed in this study shows a more robust structure than the previously published pilot version. Psychometric testing showed the NMWCQ as suitable for describing the diverse work requirements of nurse managers and may offer a framework for concretizing the job description of nurse managers.
Collapse
Affiliation(s)
- Anu Nurmeksela
- PhD, RN, Lecturer, Department of Nursing Science, Faculty of Health Sciences, University of Eastern, Finland
| | - Santtu Mikkonen
- PhD, Senior Researcher and Statistician, Department of Applied Physics, and Department of Environmental and Biological Sciences, University of Eastern Finland, Kuopio Campus, Finland
| | - Juha Kinnunen
- PhD, Director, Health Care District, Central Finland Central Hospital, Finland
| | - Tarja Kvist
- PhD, RN, Professor and Head, Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland
| |
Collapse
|
10
|
Sutak AK, Ryan SP, Hong CS, Vovos TJ, Wellman SS, Jiranek WA, Seyler TM. The Effect of Medical Education on Patient Satisfaction: An Asset or a Liability? Orthopedics 2022; 45:276-280. [PMID: 35576485 DOI: 10.3928/01477447-20220511-06] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Few studies have investigated the influence of trainee involvement on inpatient satisfaction scores in the postoperative joint arthroplasty setting. This study compares Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey scores at academic and private health care centers to assess the impact of trainees on patient satisfaction. From 2013 to 2017, 3454 HCAHPS surveys were collected at the investigating institution from patients who underwent primary total hip and total knee arthroplasty. Surveys were categorized based on the inpatient practice setting-academic hospitals included orthopedic residents and medical students who were involved in perioperative care, whereas private settings did not have trainee involvement. Patient demographics, including age, body mass index, sex, and American Society of Anesthesiologists score, were retrospectively collected. A total of 2454 HCAHPS surveys from 2 academic hospitals and 1000 surveys from a private hospital were collected. Patients at the academic hospitals were more likely to report that symptoms to look out for were clearly explained (odds ratio, 1.882; P=.001), whereas patients from the private hospital were more likely to report that the hospital was always quiet at night (odds ratio, 1.271; P=.005). The overall satisfaction score was not significantly different between the academic and private settings (78.9 vs 80.2, respectively; P=.111). The overall hospital satisfaction score for patients undergoing primary total hip and knee arthroplasty was not significantly different between private and academic medical facilities. Thus, this study supports the idea that training future orthopedic surgeons will not negatively impact patient satisfaction scores in a way that affects reimbursement. [Orthopedics. 2022;45(5):276-280.].
Collapse
|
11
|
Jain N, Sahu MRK, Singh AR, Sharma P. A decision framework model for hospital selection in COVID-19 pandemic: A FIS approach. INTERNATIONAL JOURNAL OF HEALTHCARE MANAGEMENT 2022. [DOI: 10.1080/20479700.2022.2095839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Affiliation(s)
- Naveen Jain
- Department of Mechanical Engineering, Shri Shankaracharya Institute of Professional Management and Technology, Raipur, India
| | - Manish R. K. Sahu
- Department of Mechanical Engineering, Shri Shankaracharya Institute of Professional Management and Technology, Raipur, India
| | - A. R. Singh
- Department of Mechanical Engineering, National Institute of Technology, Raipur, India
| | - Prateek Sharma
- Department of Mechanical Engineering, Shri Shankaracharya Institute of Professional Management and Technology, Raipur, India
| |
Collapse
|
12
|
Gravelle H, Liu D, Santos R. How do clinical quality and patient satisfaction vary with provider size in primary care? Evidence from English general practice panel data. Soc Sci Med 2022; 301:114936. [PMID: 35367906 DOI: 10.1016/j.socscimed.2022.114936] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 03/11/2022] [Accepted: 03/18/2022] [Indexed: 11/26/2022]
Abstract
We examine the relationship between general practice list size and measures of clinical quality and patient satisfaction. Using data on all English practices from 2005/6 to 2016/17, we estimate practice level models with rich data on patient demographics, deprivation, and morbidity. We use lagged list size to allow for potential simultaneity bias from the effect of quality on list size. We compare results from three different estimation methods: pooled ordinary least squares, random practice effects, fixed practice effects. With all three estimation methods increased list size is associated with reductions in all four measures of patient satisfaction. Increases in list size are associated with worse performance on three clinical quality indicators and better performance on three, though the precision and size of the associations varies with the estimation method. The absolute values of the elasticities of the ten quality indicators with respect to list size are small: in all cases a 10% change in list size would change quality by less than 1%. The lack of evidence that large practices have markedly better quality suggests that encouraging practices to form larger, but looser, groupings, may not, in itself, improve their performance.
Collapse
Affiliation(s)
- Hugh Gravelle
- Economics of Social and Health Care Research Unit, Centre for Health Economics, University of York, York, YO10 5DD, United Kingdom.
| | - Dan Liu
- Economics of Social and Health Care Research Unit, Centre for Health Economics, University of York, York, YO10 5DD, United Kingdom; Centre for Health Economics Research and Evaluation, University of Technology Sydney, PO Box 123, Broadway, NSW, 2007, Australia.
| | - Rita Santos
- Economics of Social and Health Care Research Unit, Centre for Health Economics, University of York, York, YO10 5DD, United Kingdom.
| |
Collapse
|
13
|
Moslehpour M, Shalehah A, Rahman FF, Lin KH. The Effect of Physician Communication on Inpatient Satisfaction. Healthcare (Basel) 2022; 10:healthcare10030463. [PMID: 35326941 PMCID: PMC8954154 DOI: 10.3390/healthcare10030463] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2022] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 12/16/2022] Open
Abstract
(1) Background: The importance of physician-patient communication and its effect on patient satisfaction has become a hot topic and has been studied from various aspects in recent years. However, there is a lack of systematic reviews to integrate recent research findings into patient satisfaction studies with physician communication. Therefore, this study aims to systematically examine physician communication’s effect on patient satisfaction in public hospitals. (2) Methods: Using a keywords search, data was collected from five databases for the papers published until October 2021. Original studies, observational studies, intervention studies, cross-sectional studies, cohort studies, experimental studies, and qualitative studies published in English, peer-reviewed research, and inpatients who communicated with the physician in a hospital met the inclusion criteria. (3) Results: Overall, 11 studies met the inclusion criteria from the 4810 articles found in the database. Physicians and organizations can influence two determinants of inpatient satisfaction in physician communication. Determinants of patient satisfaction that physicians influence consist of amounts of time spent with the patient, verbal and nonverbal indirect interpersonal communication, and understanding the demands of patients. The organization can improve patient satisfaction with physician communication by the organization’s availability of interpreter service and physician workload. Physicians’ communication with inpatients can affect patient satisfaction with hospital services. (4) Conclusions: To improve patient satisfaction with physician communication, physicians and organizational determinants must be considered.
Collapse
Affiliation(s)
- Massoud Moslehpour
- Department of Business Administration, College of Management, Asia University, No. 500, Liufeng Road, Wufeng District, Taichung City 41354, Taiwan; (M.M.); (A.S.)
- Department of Management, California State University, San Bernardino, CA 92407, USA
| | - Anita Shalehah
- Department of Business Administration, College of Management, Asia University, No. 500, Liufeng Road, Wufeng District, Taichung City 41354, Taiwan; (M.M.); (A.S.)
- International Relations Department, Faculty of Economy, Bussines and Politics, Universitas Muhammadiyah Kalimantan Timur, Jl. Ir. H. Juanda No. 15, Samarinda 75124, Kalimantan Timur, Indonesia
| | - Ferry Fadzlul Rahman
- Department of Public Health, College of Public Health, Universitas Muhammadiyah Kalimantan Timur, Jl. Ir. H. Juanda No. 15, Samarinda 75124, Kalimantan Timur, Indonesia;
| | - Kuan-Han Lin
- Department of Healthcare Administration, College of Medical and Health Sciences, Asia University, No. 500, Liufeng Road, Wufeng District, Taichung City 41354, Taiwan
- Correspondence:
| |
Collapse
|
14
|
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.
Collapse
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
| |
Collapse
|
15
|
Harrichandparsad A, Mahomed OH. Patient and health system determinants of experiences of care at primary health care clinics in eThekwini, KwaZulu-Natal, 2018. Afr J Prim Health Care Fam Med 2021; 13:e1-e8. [PMID: 34636611 PMCID: PMC8517733 DOI: 10.4102/phcfm.v13i1.2884] [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: 12/22/2020] [Revised: 07/31/2021] [Accepted: 08/05/2021] [Indexed: 11/16/2022] Open
Abstract
Background Respect for persons includes three sub-elements: dignity, autonomy and confidentiality, whilst client orientation has four sub-elements: prompt attention, quality of basic amenities, access to social support for hospitalised individuals and choice of health providers. Aim This study sought to determine patient and health system determinants of experiences of care. Setting Study was conducted at primary health care clinics in eThekwini, KwaZula-Natal. Methods A self-administered questionnaire was used to collect data from 384 patients who received ambulatory care at six primary health care facilities (three community healthcare centres and three clinics) between June 2018 and November 2018. Results Three hundred and sixty nine respondents were included in the study. Eighty one percent (299) of the respondents were female, 67.2% (248) were single and 89.7% (331) were black Africans. Fifty (13.6%) respondents reported their health status to be poor, whilst 47 (12.5%) reported excellent health, with the majority (72.0%) reporting ‘good’ or ‘fair’ health. The patients’ experience score for the study population was 89.0% (IQR 81% – 98%). Patients who attended clinics had a 6.53 (p < 0.001) times increased odds of reporting good patients’ experience score compared with patients who attended community healthcare centres. Although ideal clinic status had a positive association with patients’ experience score (odds ration [OR]: 1.75; p > 0.05) this was not significant. Conclusion Patients attending clinics had a better experience compared with community health centres. Ideal clinic status showed a positive but not statistical significant association with good patient experiences. This may suggest that factors other than structural improvements play an important role in patients’ experience.
Collapse
|
16
|
Spine Surgery HCAHPS Patient Satisfaction Survey Results Inversely Correlate with Survey Response Time. Spine (Phila Pa 1976) 2021; 46:1264-1270. [PMID: 34435990 DOI: 10.1097/brs.0000000000003974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
STUDY DESIGN Retrospective review. OBJECTIVE The aim of this study was to understand the potential correlation of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey response time on reported satisfaction following spine surgery hospitalization. SUMMARY OF BACKGROUND DATA With increasing emphasis on patient satisfaction metrics, such as HCAHPS, hospital reputations, and reimbursements are being affected by the results of such surveys. HCAHPS is a 32-question survey about patient experience in the hospital and after discharge. METHODS HCAHPS surveys were routinely sent to all patients admitted after spine surgery at an academic medical center between January 2013 and August 2017. Survey data, survey return time, patient demographics, and 30-day postoperative outcomes were gathered for all spine surgery patients who returned the survey. Multivariate regression analysis controlling for age, sex, BMI, functional status, American Society of Anesthesiologists class, education, and race was used to determine whether there were differences in rates of "Top Box" response between different time ranges of survey return. RESULTS In total, 1495 consecutive spinal surgery patients who returned their HCAHPS survey were identified. Of these, 31.51% returned their surveys within 21 days, 48.09% returned them between 22 to 42 days, 13.58% returned them between 43 to 64 days, and 6.82% returned them ≥65 days after distribution. Multivariate regression demonstrated no statistical differences in reported satisfaction between surveys returned between days 0 to 21 and days 22 to 42. However, there were significantly lower scores reported by surveys returned on days 43 to 64 and 65 plus days. CONCLUSION Centers for Medicare and Medicaid Services only considers HCAHPS surveys returned within the first 42 days. It appears that the survey responses are similar over this time period. Beyond this time, lower scores are reported. Further attention to this less satisfied, later HCAHPS survey returning group seems warranted.Level of Evidence: 2.
Collapse
|
17
|
Shah KC, Dominy C, Tang J, Geng E, Arvind V, Pasik S, Yeshoua B, Kim JS, Cho SK. Significance of Hospital Size in Outcomes of Single-Level Elective Anterior Cervical Discectomy and Fusion: A Nationwide Readmissions Database Analysis. World Neurosurg 2021; 155:e687-e694. [PMID: 34508911 DOI: 10.1016/j.wneu.2021.08.122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 08/25/2021] [Accepted: 08/26/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVE To elucidate risk factors for 90-day readmission in anterior cervical discectomy and fusion (ACDF) for small, medium, and large hospitals. To assess differences in length of stay, charges, and complication rates across hospitals of different size. METHODS A retrospective analysis was performed using elective, single-level ACDF data from 2016 to 2018 in the Healthcare Cost and Utilization Project Nationwide Readmissions Database. Elective single-level ACDF cases were stratified into 3 groups by hospital bed size (small, medium, and large). All-cause complication rates, mean charges, length of stay, and 90-day readmission rates were compared across hospital size. Frequencies of specific comorbidities were compared between readmitted and nonreadmitted patients for each hospital size. Comorbidities significant on univariate analysis were evaluated as independent risk factors for 90-day readmission for each hospital size using multivariate regression. RESULTS The overall 90-day readmission rate was 6.43% in 36,794 patients, and the rates for small, medium, and large hospitals were 6.25%, 6.28%, and 6.56%, respectively (P = 0.537). Length of stay increased significantly with hospital size (P < 0.001), and small hospitals had the lowest charges (P < 0.001). Although different independent predictors of 90-day readmission were identified for each hospital size, cardiac arrhythmia, chronic pulmonary disease, neurologic disorders, and rheumatic disease were identified as risk factors for hospitals of all sizes. CONCLUSIONS Hospital size is a determining factor for charges and length of stay associated with elective single-level ACDF. Variation in risk factors for readmission exists across hospital size in context of similar 90-day readmission rates.
Collapse
Affiliation(s)
- Kush C Shah
- Department of Orthopedic Surgery, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Calista Dominy
- Department of Orthopedic Surgery, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Justin Tang
- Department of Orthopedic Surgery, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Eric Geng
- Department of Orthopedic Surgery, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Varun Arvind
- Department of Orthopedic Surgery, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Sara Pasik
- Department of Orthopedic Surgery, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Brandon Yeshoua
- Department of Orthopedic Surgery, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Jun S Kim
- Department of Orthopedic Surgery, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Samuel K Cho
- Department of Orthopedic Surgery, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
| |
Collapse
|
18
|
Tobler S, Stummer H. Determinants of inpatient satisfaction: evidence from Switzerland. Int J Health Care Qual Assur 2021; ahead-of-print. [PMID: 33350289 DOI: 10.1108/ijhcqa-03-2020-0044] [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] [Indexed: 11/17/2022]
Abstract
PURPOSE A common way to handle quality problems and increasing costs of modern health care systems is more transparency through public reporting. Thereby, patient satisfaction is seen as one main reported outcome. Previous studies proposed several associated factors. Only a few of them included organizational determinants with potential to inform the health care provider's management. Therefore, the aim of this study was to investigate the influence of organizational contingency factors on patient satisfaction. DESIGN/METHODOLOGY/APPROACH As a case, Switzerland's inpatient rehabilitation sector was used. Therein, a cross-sectional study of public released secondary data with an exploratory multiple linear regression (MLR) modeling approach was conducted. FINDINGS Five significant influencing factors on patient satisfaction were found. They declared 42.2% of the variance in satisfaction on provider level. The organizations' supplementary insured patients, staff payment, outpatients, extracantonal patients and permanent resident population revealed significant correlations with patient satisfaction. RESEARCH LIMITATIONS/IMPLICATIONS Drawing on publicly available cross-sectional data, statistically no causality can be proved. However, integration of routine data and organization theory can be useful for further studies. PRACTICAL IMPLICATIONS Regarding inpatient satisfaction, improvement levers for providers' managers are as follow: first, service provision should be customized to patients' needs, expectations and context; second, employees' salary should be adequate to prevent dissatisfaction; third, the main business should be prioritized to avoid frittering. ORIGINALITY/VALUE Former studies regarding public reporting are often atheoretical and rarely used organizational variables as determinants for relevant outcomes. Therefore, uniformed data are useful.
Collapse
Affiliation(s)
- Stephan Tobler
- Institute for Management and Economics in Health Care, Private University of Health Sciences Medical Informatics and Technology, Hall, Austria
| | - Harald Stummer
- Institute for Management and Economics in Health Care, Private University of Health Sciences Medical Informatics and Technology, Hall, Austria
- Institute for Health Management and Innovation, University Seeburgcastle, Seekirchen am Wallersee, Austria
| |
Collapse
|
19
|
Cardinali F, Carzaniga S, Duranti G, Labella B, Lamanna A, Cerilli M, Caracci G, Carinci F. A nationwide participatory programme to measure person-centred hospital care in Italy: Results and implications for continuous improvement. Health Expect 2021; 24:1145-1157. [PMID: 34014021 PMCID: PMC8369125 DOI: 10.1111/hex.13231] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 02/01/2021] [Accepted: 02/21/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Patient-centredness has been targeted by the Italian government as a key theme for the future development of health services. OBJECTIVE Measuring patient-centred health services in partnership with citizens, health professionals and decision makers. DESIGN National participatory survey in a large test set of hospitals at national level. SETTING AND PARTICIPANTS A total of 387 hospital visits conducted in 16 Italian regions by over 1,500 citizens and health professionals during 2017-2018. MAIN VARIABLES AND OUTCOME MEASURES An ad hoc checklist was used to assess person-centredness in hospital care through 243 items, grouped in 4 main areas, 12 sub-areas and 29 person-centred criteria (scored 0-10). GEE linear multivariate regression was used to explore the relation between hospital characteristics and person-centredness. RESULTS Person-centred scores were moderately high, with substantial variation overall (median score: 7.0, range: 3.2-9.5) and by area (Care Processes: 6.8, 2.0-9.8; Access: 7.4, 2.7-9.7; Transparency: 6.7, 3.4-9.5 and Relationship: 7.3, 0.8-10.0). Multivariate regression found higher scores for increasing volumes of activity (quartile increase: +0.21; 95% CI: 0.13, 0.29) and lower scores in the south and islands (-1.03; -1.62,-0.45). DISCUSSION The checklist has been applied successfully by over 1,500 collaborators who assessed hospitals in 16 distinct Regions and Autonomous Provinces of Italy. Despite an overall positive mark, all scores were highly variable by location and hospital characteristics. CONCLUSION AND PATIENT OR PUBLIC CONTRIBUTION A national participatory programme to improve patient-centredness in Italian hospitals highlighted critical areas with the direct input of citizens.
Collapse
Affiliation(s)
- Flavia Cardinali
- Italian National Agency for Regional Health Services (AGENAS)RomaItaly
| | - Sara Carzaniga
- Italian National Agency for Regional Health Services (AGENAS)RomaItaly
| | - Giorgia Duranti
- Italian National Agency for Regional Health Services (AGENAS)RomaItaly
| | - Barbara Labella
- Italian National Agency for Regional Health Services (AGENAS)RomaItaly
| | | | - Micaela Cerilli
- Italian National Agency for Regional Health Services (AGENAS)RomaItaly
| | - Giovanni Caracci
- Italian National Agency for Regional Health Services (AGENAS)RomaItaly
| | - Fabrizio Carinci
- Italian National Agency for Regional Health Services (AGENAS)RomaItaly
- University of BolognaBolognaItaly
| |
Collapse
|
20
|
Theuring S, Kengonzi A, Hafermann L, Herrmann C, Kabwama SN, Rubaihayo J. Repercussions of the COVID-19 Response in Pregnant Women in Western Uganda: Knowledge, Behavior, and Emotional State after the First Lockdown in 2020. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7817. [PMID: 34360111 PMCID: PMC8345751 DOI: 10.3390/ijerph18157817] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/16/2021] [Accepted: 07/18/2021] [Indexed: 11/16/2022]
Abstract
Limited research exists on pregnant women's knowledge, attitudes, and behavior concerning COVID-19 in sub-Saharan Africa. We performed a cross-sectional study among 648 pregnant women in Fort Portal, Uganda, after the first lockdown starting in June 2020. Structured interviews were conducted at three different facilities during routine antenatal care, assessing sociodemographic background, knowledge of COVID-19, prevention behavior adherence, and psycho-emotional stress levels. We performed descriptive analyses and examined associated factors using multivariable logistic regression. In Fort Portal Region, 32.8% of pregnant women had a higher knowledge regarding the COVID-19 pandemic, while all women at least heard of COVID-19. 88.6% of the women showed low self-reported prevention behavior adherence. More than one third of the pregnant women experienced high psycho-emotional stress related to the pandemic (39.8%). The odds for psycho-emotional stress were increased among the age group 21-30 years (AOR 1.97; 95% CI 1.18-3.35) compared to women under the age of 21, and decreased in single or divorced women compared to women in partnerships (AOR 0.42; 0.22-0.77) and in women having less COVID-19-related knowledge (AOR 0.40; 0.27-0.58). In conclusion, prevention behavior adherence seemed challenging, and psycho-emotional stress was ubiquitous among our cohort. To avoid adverse consequences in maternal and neonatal health, campaigns for hygiene but also women's emotional state should be a major focus of community healthcare in exceptional times such as the SARS-CoV-2 pandemic.
Collapse
Affiliation(s)
- Stefanie Theuring
- Institute of Tropical Medicine and International Health, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 13353 Berlin, Germany
| | - Agnes Kengonzi
- School of Health Sciences, Mountains of the Moon University, Fort Portal P.O. Box 837, Uganda; (A.K.); (J.R.)
| | - Lorena Hafermann
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (L.H.); (C.H.)
| | - Carolin Herrmann
- Institute of Biometry and Clinical Epidemiology, Charité-Universitätsmedizin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, 10117 Berlin, Germany; (L.H.); (C.H.)
| | | | - John Rubaihayo
- School of Health Sciences, Mountains of the Moon University, Fort Portal P.O. Box 837, Uganda; (A.K.); (J.R.)
| |
Collapse
|
21
|
Park C, Zakare-Fagbamila RT, Dickson W, Garcia AN, Gottfried ON. The limited influence of neurosurgeons' behavior on inpatient satisfaction: a retrospective multihospital analysis. J Neurosurg 2021; 134:1983-1989. [PMID: 32736359 DOI: 10.3171/2020.5.jns20923] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 05/04/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) is a survey that assesses patient satisfaction, which is an important measure of the quality of hospital care and ultimately the overall hospital rating (OHR). However, the survey covers several elements of patient satisfaction beyond the patient-surgeon interaction. In this study, authors investigated which admission and experience factors had the highest impact on the OHR. METHODS This was a retrospective cohort analysis of HCAHPS surveys from patients who, in the period between August 1, 2016, and January 31, 2018, had been discharged from the neurosurgical or orthopedic service at three hospitals serving a single metropolitan area. The top-box score was defined as the highest rating obtainable for each survey question. Baseline admission attributes were obtained, and multivariate logistic regression was used to determine predictors of the top-box OHR. RESULTS After application of the inclusion and exclusion criteria, 1470 patients remained in the analysis. Categories on the HCAHPS included OHR, communication, education, environment, pain management, and responsiveness. After excluding identifying questions from the survey and adjusting for subspecialty and hospital, 7 of 17 HCAHPS survey items were significant predictors of OHR. Only 2 of these were related to the surgeon: 1) discharge, "Did you get information in writing about what symptoms or health problems to look out for after you left the hospital?" (OR 5.93, 95% CI 2.52-13.94); and 2) doctor, "Did doctors explain things in a way you could understand?" (OR 2.78, 95% CI 1.73-4.46). The top three strongest correlating items were 1) discharge; 2) nursing, "Did nurses treat you with courtesy and respect?" (OR 3.86, 95% CI 2.28-6.52); and 3) hospital environment, "Were your room and bathroom kept clean?" (OR 2.86, 95% CI 1.96-4.17). CONCLUSIONS The study findings demonstrated that there are several nonmodifiable factors (i.e., specialty, experience) and items that are not under the direct purview of the neurosurgeon (e.g., nursing communication, hospital environment) that are significant influences on overall inpatient satisfaction on the HCAHPS survey. Furthermore, components of the survey that ultimately influence the OHR vary across different hospitals. Hence, HCAHPS survey results should be broadly interpreted as a way to make health systems more aware of the overall hospital factors that can improve quality of care and patient experience.
Collapse
Affiliation(s)
- Christine Park
- 1Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | | | - Wes Dickson
- 3Department of Performance Services, Duke University Health System, Durham; and
| | - Alessandra N Garcia
- 4Division of Doctor of Physical Therapy, Department of Orthopaedic Surgery, Duke University, Durham, North Carolina
| | - Oren N Gottfried
- 1Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| |
Collapse
|
22
|
Ren W, Sun L, Tarimo CS, Li Q, Wu J. The situation and influencing factors of outpatient satisfaction in large hospitals: Evidence from Henan province, China. BMC Health Serv Res 2021; 21:500. [PMID: 34034724 PMCID: PMC8145824 DOI: 10.1186/s12913-021-06520-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 05/12/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The level of outpatient satisfaction plays a significant role in improving the quality and utilization of healthcare services. Patient satisfaction gives providers insights into various aspects of services including the effectiveness of care and level of empathy. This study aimed to evaluate the level of patient satisfaction in the outpatient department and to explore its influencing factors in large hospitals (accommodating over 1000 beds) of Henan province, China. METHODS We analyzed data from Henan Large Hospitals Patient Satisfaction Survey conducted in the year 2018 and included 630 outpatients. Structural Equation Model (SEM) was used to explore the relationship among evaluation indicators of outpatient satisfaction levels. We used Dynamic Matter-Element Analysis (DMA) to evaluate the status of outpatient satisfaction. Binary Logistic Regression (BLR) was adopted to estimate the impact of personal characteristics towards outpatient satisfaction. RESULTS The overall score for outpatient satisfaction in large hospitals was 66.28±14.73. The mean outpatient satisfaction scores for normal-large, medium-large, and extra-large hospitals were 63.33±12.12, 70.11±16.10, 65.41±14.67, respectively, and were significantly different (F = 11.953, P < 0.001). Waiting time, doctor-patient communication, professional services, and accessibility for treatment information were shown to have directly positive correlations with outpatient satisfaction (r = 0.42, 0.47, 0.55, 0.46, all P < 0.05). Results from BLR analysis revealed that patients' age and frequency of hospital visits were the main characteristics influencing outpatient satisfaction (P < 0.05). CONCLUSIONS The outpatient satisfaction of large hospitals is moderately low. Hospital managers could shorten the waiting time for outpatients and improve the access to treatment information to improve the satisfaction of outpatients. It is also necessary to enhance service provision for outpatients under the age of 18 as well as the first-time patients.
Collapse
Affiliation(s)
- Weicun Ren
- College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
- College of Sanquan, Xinxiang Medical University, Xinxiang, People's Republic of China
| | - Lei Sun
- College of Sanquan, Xinxiang Medical University, Xinxiang, People's Republic of China
| | - Clifford Silver Tarimo
- College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
- Department of Science and Laboratory Technology, Dares Salaam Institute of Technology, Dares Salaam, Tanzania
| | - Quanman Li
- College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China
| | - Jian Wu
- College of Public Health, Zhengzhou University, Zhengzhou, People's Republic of China.
- College of Sanquan, Xinxiang Medical University, Xinxiang, People's Republic of China.
| |
Collapse
|
23
|
Nurmeksela A, Mikkonen S, Kinnunen J, Kvist T. Relationships between nurse managers' work activities, nurses' job satisfaction, patient satisfaction, and medication errors at the unit level: a correlational study. BMC Health Serv Res 2021; 21:296. [PMID: 33794875 PMCID: PMC8017674 DOI: 10.1186/s12913-021-06288-5] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 03/17/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Nurse managers play a critical role in enhancing nursing and patient outcomes. The work of nurse managers, who can be described as middle-managers at health care organizations, is complex and changes on a daily basis. Only a few studies have clarified how nurse managers divide their time across various work activities. This study aimed to describe the relationships between nurse managers' work activities, nurses' job satisfaction, patient satisfaction, and medication errors at the hospital unit level. METHODS A cross-sectional and correlational study design was used. The data were collected from nurse managers (n = 29), nursing staff (n = 306), and patients (n = 651) from 28 units across three Finnish acute care hospitals between April and November 2017. In addition, data concerning medication errors (n = 468) over one calendar year (2017) were acquired from the hospitals' incident reporting register. Analysis of covariance (ANCOVA) was used to estimate relationships between data from subareas of Nurse Managers' Work Content Questionnaire, Kuopio University Hospital Job Satisfaction Scale, and Revised Humane Caring Scale, along with medication error reports. A significance level of 95% was applied when estimating the covariances between variables. Unstandardized regression coefficients (B) were used to explain the relationships between variables. RESULTS Multiple relationships between nurse managers' work activities, nurses' job satisfaction, patient satisfaction, and medication errors were identified. Nurse managers' work activities had both positive and negative relationships on the other studied variables. The Requiring factors of work (p < .001) subarea of nurses' job satisfaction, total patient satisfaction (p < .001), and medication errors (p < .001) were identified as the variables most significantly affected by other factors. CONCLUSIONS The findings suggest that nurse managers should focus on improving nursing practices by managing and organizing nurses' work in a way that makes their employees feel supported, motivated and secure. Furthermore, nurse managers should adopt a leadership style that emphasizes safe and patient-centered care. The results also suggest that the administration of today's health care organizations should actively evaluate nurse managers' share of work activities to ensure that their daily work is in line with the organizational goals.
Collapse
Affiliation(s)
- Anu Nurmeksela
- Faculty of Health Sciences, Department of Nursing Science, University Teacher, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Santtu Mikkonen
- Department of Applied Physics and Department of Environmental and Biological Sciences, University of Eastern Finland, P.O. Box 1627, 70211 Kuopio, Finland
| | - Juha Kinnunen
- Central Finland Central Hospital, Keskussairaalantie 19, 40620 Jyväskylä, Finland
| | - Tarja Kvist
- Department of Nursing Science, Faculty of Health Sciences, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, 70211 Kuopio, Finland
| |
Collapse
|
24
|
Zhang X, Li P, Zhang C, Guo P, Wang J, Liu N, Yang S, Yu L, Zhang W. Breast Cancer Screening Practices and Satisfaction With Healthcare Providers in Chinese Women: A Cross-sectional Study. Cancer Nurs 2021; 45:E573-E581. [PMID: 33813526 DOI: 10.1097/ncc.0000000000000942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The Chinese government has proposed cancer screening guidelines and launched 2 cancer screening programs to improve screening practices. However, the screening participation rates of Chinese women remain low. Exploring the factors affecting breast cancer screening to promote cancer screening is necessary. OBJECTIVE The aim of this study was to investigate women's satisfaction with healthcare providers and screening practices. METHODS A cross-sectional survey was conducted from November 2019 to April 2020 in Changchun, Jilin Province, China. The Medical Care Satisfaction Scale and SERVQUAL were used to quantify women's satisfaction with doctors and nurses, respectively. RESULTS Women's satisfaction with doctors (68.81 ± 11.08; range, 20-100) and with nurses (87.64 ± 16.17; range, 22-110) was moderate. Compared with women who had not participated in screening within the past 2 years, screened women reported higher satisfaction with doctors (P = .026) and nurses (P = .012). Older age (P = .004) was an independent predictor of women's satisfaction with doctors. Similarly, women's education level (P = .049), chronic disease history (P = .029), and physical examination history (P = .039) were 3 independent predictors of women's satisfaction with nurses. CONCLUSIONS Future intervention strategies can not only increase the screening rates by providing existing intervention methods but also improve women's satisfaction with healthcare providers to promote screening practices. IMPLICATIONS FOR PRACTICE This article provides a theoretical basis for healthcare providers to increase female screening practices. It also provides references for improving existing intervention methods.
Collapse
Affiliation(s)
- Xuehui Zhang
- Author Affiliations: Nursing School, Jilin University (Mss X Zhang, Guo, Wang, Liu, Yang, and Yu, and Dr W Zhang); and the Second Hospital of Jilin University (Dr Li and Ms C Zhang), Changchun, China
| | | | | | | | | | | | | | | | | |
Collapse
|
25
|
Chang M, Russo GS, Canseco JA, Nicholson K, Sharma R, Koomson J, Vaccaro AR. Variations in Patient Satisfaction Scores Between HCAHPS and a Novel Orthopedic Practice-Specific Survey. Am J Med Qual 2021; 36:103-109. [PMID: 32452696 DOI: 10.1177/1062860620926710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Performance on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey can affect up to 33% of a physician's reimbursement from the Centers for Medicare & Medicaid Services. At this pseudo-private orthopedic practice, the authors characterized how physicians often achieve drastically different scores between HCAHPS and an Internal Patient Satisfaction Questionnaire (IPSQ). Eighteen physicians were ranked separately according to percentage of top-box scores on HCAHPS and IPSQ. There was an inverse relationship between physician rank for the 2 surveys according to Spearman correlation coefficient (ρ = -0.36, P = .15). Qualitative subanalysis indicated that although "physician interaction" was the most common reason for negative comments on HCAHPS, "ancillary staff" and "workflow" concerns were common on IPSQ. The outpatient setting remains a critical component in achieving high-quality orthopedic care. Consequently, HCAHPS alone may not be a sufficient indicator of patient satisfaction for orthopedic and other subspecialty practices.
Collapse
Affiliation(s)
- Michael Chang
- Rothman Orthopaedic Institute at Thomas Jefferson University, Philadelphia, PA Quinnipiac University, Hamden, CT Drexel University, Philadelphia, PA
| | | | | | | | | | | | | |
Collapse
|
26
|
Sun Z, Wang S, Zhao H, Yu H. Does Descending Resources Reform Improve Patient Satisfaction and Reshape Choice of Care Providers? A Cross-Sectional Study in Zhejiang, China. INQUIRY: The Journal of Health Care Organization, Provision, and Financing 2020; 57:46958020956899. [PMID: 32909479 PMCID: PMC7488616 DOI: 10.1177/0046958020956899] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Patient satisfaction and choice of care providers have been the core concerns of
China’s descending resources reform launched in 2013. This health care reform
attempts to improve low-level hospitals’ capability and patient satisfaction
through compulsory descending of doctors from high-level hospitals, thereby
reshaping patients’ behavior (loyalty). The goal of this paper is to explore the
determinants of patient satisfaction, and its impact on patient loyalty with an
emphasis on low-level hospitals in the reform context. By using a self-made
5-point scale that incorporates socio-demographic variables, reform, and
revealed preference into the European Consumer Satisfaction Index model (ECSI),
cross-sectional data from 17 hospitals, and 1287 questionnaires in Zhejiang
province is collected to conduct empirical research. Satisfaction is measured as
ordinary variables with the reform and with the low-level hospitals,
respectively. Loyalty is measured by patients’ willingness to choose low-level
hospitals when suffering illness or severe illness. Analysis of variance and
multiple comparisons are utilized to examine the different level of hospitals.
An ordered logit model and ordinary least squares regression are applied to
examine the determinants of satisfaction and loyalty. The results indicate that
patient satisfaction can be explained by variables of perceived quality, patient
expectations, and corporate image. Socio-demographic variable, providers, and
the reform also have significant effects. Patients’ satisfaction plays a
pronounced role on improving their loyalty. The descending resources reform
positively affects low-level hospitals’ capability and patient satisfaction. The
cost reduction and convenience significantly increase the reform satisfaction.
Capability, medical environment, and accessibility of descending doctors are
positively associated with the satisfaction with low-level hospitals. This paper
evidences that the descending resources reform is an effective way to reallocate
resources in supply side of health service market and reshape patients’ choice
of care providers with the accessibility and spillover of descending human
capital.
Collapse
Affiliation(s)
- Zesheng Sun
- School of Finance and Business, Shanghai Normal University, China
| | - Shuhong Wang
- Department of Stomatology, Tongde Hospital of Zhejiang Province, Hangzhou, China.,Department of Stomatology, First People's Hospital of Akesu, China
| | - Hongjun Zhao
- School of Finance and Business, Shanghai Normal University, China
| | - Haiming Yu
- School of Economics and Management, Zhejiang University of Science and Technology, Hangzhou, China
| |
Collapse
|
27
|
Özkan Ş, Chiang C, Aba G, Çelik Y. Satisfaction with maternal and birth services: a survey in public hospitals in Turkey. Int J Health Care Qual Assur 2020; 33:363-372. [PMID: 32840968 DOI: 10.1108/ijhcqa-08-2019-0146] [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: 11/17/2022]
Abstract
PURPOSE The purpose of this study was to determine the satisfaction of women who underwent normal delivery and cesarean section (or C-section) with maternal care in five state-run hospitals in Northwestern Turkey. DESIGN/METHODOLOGY/APPROACH This was a cross-sectional study. The sample consisted of 580 women who underwent normal delivery (ND) and 392 who had a C-section (CS). Data were collected using two maternal satisfaction questionnaires, which participants completed right before they were discharged. FINDINGS More than half of ND (61.7%) and CS (56.9%) participants were satisfied with maternal care. ND participants who had received antenatal training were more satisfied with maternal care than CS participants who had not received antenatal training. Higher income was a significant predictor for reduced satisfaction with maternal care among CS participants (p = 0.031). PRACTICAL IMPLICATIONS Hospital administrators and decision-makers should meet women's expectations, provide them with comfort, encourage them for skin-to-skin contact and respect their right to privacy in order to increase their satisfaction with maternal care. Pregnant women should also be encouraged to receive antenatal training offered by hospitals before delivery. ORIGINALITY/VALUE The evidence-based results of the study will help hospital administrators to improve healthcare quality and focus on increasing women's satisfaction with maternal care.
Collapse
Affiliation(s)
- Şirin Özkan
- Bandirma Onyedi Eylul Universitesi, Bandirma, Turkey
| | | | - Gökhan Aba
- Bandirma Onyedi Eylul Universitesi, Bandirma, Turkey
| | | |
Collapse
|
28
|
The Impact of Service Quality on Patient Satisfaction and Revisiting Intentions: The Case of Public Emergency Departments. Qual Manag Health Care 2020; 28:200-208. [PMID: 31567843 DOI: 10.1097/qmh.0000000000000232] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND AND OBJECTIVES This study attempts to (a) identify the main quality indicators that affect "service quality" and (b) examine the effect of "patient satisfaction" on patient "revisiting intentions." METHODS The sample includes patients of 2 hospitals, 1 urban and 1 provincial. The comparative analysis of 2 emergency departments (EDs) with different characteristics aims at understanding their diverse problems and their specific needs from a patient point of view. Empirical data were collected in the fall of 2015. Three hundred questionnaires were distributed in person. A total of 169 valid questionnaires, 80 from hospital A and 89 from hospital B, were returned, with a response rate of 56.3%. RESULTS The Structural Equation Modeling technique revealed that overall satisfaction is strongly influenced by "perceived service quality" (β = .79), while it positively affects patient "behavioral intentions" (β = .39). Also, "perceived waiting time" proved to have a more intense impact on "perceived service quality" (β = -.59), rather than on "perceived technical and functional quality" (β = .18). Moreover, it was determined that patients visiting the urban ED pay more attention in waiting times, while patients visiting the provincial ED care about receiving both quality and timely health care services. Overall, the study provides insight about the main factors affecting "perceived service quality" and "overall satisfaction." These factors fall into 2 distinct categories: "perceived technical and functional quality" and "perceived waiting time." CONCLUSIONS The study concludes that "overall satisfaction" acts as a mediator between "perceived service quality" and patient "behavioral intentions," while "perceived waiting time" is the most significant indicator of service quality and the most crucial predictor of ED patient satisfaction. Moreover, it offers empirical evidence concerning the differences in the way patients rate the services offered by a hospital, based on the hospital size and the region it is located (urban or provincial).
Collapse
|
29
|
Montagu D, Landrian A, Kumar V, Phillips BS, Singhal S, Mishra S, Singh S, Cotter SY, Singh VP, Kajal F, Sudhinaraset M. Patient-experience during delivery in public health facilities in Uttar Pradesh, India. Health Policy Plan 2020; 34:574-581. [PMID: 31419287 PMCID: PMC6794568 DOI: 10.1093/heapol/czz067] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/24/2019] [Indexed: 11/12/2022] Open
Abstract
In India, most women now delivery in hospitals or other facilities, however, maternal and neonatal mortality remains stubbornly high. Studies have shown that mistreatment causes delays in care-seeking, early discharge and poor adherence to post-delivery guidance. This study seeks to understand the variation of women’s experiences in different levels of government facilities. This information can help to guide improvement planning. We surveyed 2018 women who gave birth in a representative set of 40 government facilities from across Uttar Pradesh (UP) state in northern India. Women were asked about their experiences of care, using an established scale for person-centred care. We asked questions specific to treatment and clinical care, including whether tests such as blood pressure, contraction timing, newborn heartbeat or vaginal exams were conducted, and whether medical assessments for mothers or newborns were done prior to discharge. Women delivering in hospitals reported less attentive care than women in lower-level facilities, and were less trusting of their providers. After controlling for a range of demographic attributes, we found that better access, higher clinical quality, and lower facility-level, were all significantly predictive of patient-centred care. In UP, lower-level facilities are more accessible, women have greater trust for the providers and women report being better treated than in hospitals. For the vast majority of women who will have a safe and uncomplicated delivery, our findings suggest that the best option would be to invest in improvements mid-level facilities, with access to effective and efficient emergency referral and transportation systems should they be needed.
Collapse
Affiliation(s)
- Dominic Montagu
- School of Medicine, Department of Epidemiology and Biostatistics, University of California, San Francisco, Mission Hall 550 16th St. 3rd Floor, San Francisco, CA, USA
| | - Amanda Landrian
- Jonathan and Karin Fielding School of Public Health, University of California, 650 Charles E. Young Dr. South, Los Angeles, CA, USA
| | | | - Beth S Phillips
- School of Medicine, Department of Epidemiology and Biostatistics, University of California, San Francisco, Mission Hall 550 16th St. 3rd Floor, San Francisco, CA, USA
| | - Shreya Singhal
- Community Empowerment Lab, Lucknow, Uttar Pradesh, India
| | | | | | - Sun Yu Cotter
- School of Medicine, Department of Epidemiology and Biostatistics, University of California, San Francisco, Mission Hall 550 16th St. 3rd Floor, San Francisco, CA, USA
| | | | - Fnu Kajal
- National Health Mission, Lucknow, Uttar Pradesh, India
| | - May Sudhinaraset
- Jonathan and Karin Fielding School of Public Health, University of California, 650 Charles E. Young Dr. South, Los Angeles, CA, USA
| |
Collapse
|
30
|
Hu L, Ding H, Liu S, Wang Z, Hu G, Liu Y. Influence of patient and hospital characteristics on inpatient satisfaction in China's tertiary hospitals: A cross-sectional study. Health Expect 2019; 23:115-124. [PMID: 31637800 PMCID: PMC6978851 DOI: 10.1111/hex.12974] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2019] [Revised: 07/23/2019] [Accepted: 09/03/2019] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Patient satisfaction has been seen as a key criterion when evaluating hospitals and is one of the main focuses of the current health-care reform in China. This paper aimed to explore patient- and hospital-level factors associated with inpatient satisfaction, which can provide policy implications for the evaluation and development of a patient-oriented health-care system. METHODS The paper analyses data from the 2017 China National Patient Survey which includes 20 300 inpatients from 131 tertiary hospitals across 31 provinces. Descriptive analysis and multivariable logistic regressions are conducted to identify key factors related to satisfaction. RESULTS Patient sociodemographic characteristics, including gender, age, income and insurance type, are found to be strongly associated with their satisfaction of inpatient experience. In terms of institutional characteristics, hospital type, size, staffing and financial performance are also significantly correlated with inpatient satisfaction. Patients are more satisfied with specialist hospitals and large hospitals measured by the number of beds and surgeries. Hospitals with higher nurse-to-bed ratio also receive more satisfaction. The financial performance of hospitals, however, is negatively associated with satisfaction. CONCLUSION Patient satisfaction contains unique information on service quality and thus should be incorporated into the matrix of hospital evaluation. Meanwhile, differences in patient composition must be adjusted to make fair comparisons across hospitals. Moreover, future reform needs to put greater efforts in the design of comprehensive public insurance scheme, efficient hospital structure and an overall well-functioning health-care delivery system in order to better serve patients in China.
Collapse
Affiliation(s)
- LinLin Hu
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Hui Ding
- Department of Economics, Stanford University, Stanford, California
| | - Shiyang Liu
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Zijuan Wang
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| | - Guangyu Hu
- Institute for Medical Information, Chinese Academy of Medical Science, Beijing, China
| | - Yuanli Liu
- School of Public Health, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, China
| |
Collapse
|
31
|
Hirji SA, Shah RM, Fields A, Orhurhu V, Bhulani N, White A, Mody GN, Swanson SJ. The Impact of Hospital Size on National Trends and Outcomes Following Open Esophagectomy. ACTA ACUST UNITED AC 2019; 55:medicina55100669. [PMID: 31623325 PMCID: PMC6843198 DOI: 10.3390/medicina55100669] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/20/2019] [Accepted: 09/30/2019] [Indexed: 01/29/2023]
Abstract
Background and Objectives: Previous studies have demonstrated superior patient outcomes for thoracic oncology patients treated at high-volume surgery centers compared to low-volume centers. However, the specific role of overall hospital size in open esophagectomy morbidity and mortality remains unclear. Materials and Methods: Patients aged >18 years who underwent open esophagectomy for primary malignant neoplasia of the esophagus between 2002 and 2014 were identified using the National Inpatient Sample. Minimally invasive procedures were excluded. Discharges were stratified by hospital size (large, medium, and small) and analyzed using trend and multivariable regression analyses. Results: Over a 13-year period, a total of 69,840 open esophagectomy procedures were performed nationally. While the proportion of total esophagectomies performed did not vary by hospital size, in-hospital mortality trends decreased for all hospitals (large (7.2% to 3.7%), medium (12.8% vs. 4.9%), and small (12.8% vs. 4.9%)), although this was only significant for large hospitals (P < 0.01). After controlling for patient demographics, comorbidities, admission, and hospital-level factors, hospital length of stay (LOS), total inflation-adjusted costs, in-hospital mortality, and complications (cardiac, respiratory, vascular, and bleeding) did not vary by hospital size (all P > 0.05). Conclusions: After risk adjustment, patient morbidity and in-hospital mortality appear to be comparable across all institutions, including small hospitals. While there appears to be an increased push for referring patients to large hospitals, our findings suggest that there may be other factors (such as surgeon type, hospital volume, or board status) that are more likely to impact the results; these need to be further explored in the current era of episode-based care.
Collapse
Affiliation(s)
- Sameer A Hirji
- Division of Thoracic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Rohan M Shah
- Division of Thoracic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Adam Fields
- T. H. Chan Harvard School of Public Health, Boston, MA 02115, USA.
| | - Vwaire Orhurhu
- T. H. Chan Harvard School of Public Health, Boston, MA 02115, USA.
| | - Nizar Bhulani
- T. H. Chan Harvard School of Public Health, Boston, MA 02115, USA.
| | - Abby White
- Division of Thoracic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| | - Gita N Mody
- Division of Cardiothoracic Surgery, University of North Carolina, Chapel Hill, NC 27599-7065, USA.
| | - Scott J Swanson
- Division of Thoracic Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA.
| |
Collapse
|
32
|
Sillero-Sillero A, Zabalegui A. Safety and satisfaction of patients with nurse's care in the perioperative. Rev Lat Am Enfermagem 2019; 27:e3142. [PMID: 31038636 PMCID: PMC6528624 DOI: 10.1590/1518-8345.2646.3142] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 01/27/2018] [Indexed: 01/27/2023] Open
Abstract
OBJECTIVE to investigate the safety and satisfaction of patients and their relationship with nurse's care in the perioperative period. METHOD cross-sectional, multi-level, correlational study with 105 nurses in the surgical area and 150 patients operated in a Spanish tertiary hospital. For the nurses the sociodemographic variables, the perception of the work environment, the professional burnout and the satisfaction in the work were collected. For patients, the safety of adverse events and level of satisfaction, through the application of questionnaires. Univariate and multivariate analysis were used. RESULTS job satisfaction, professional commitment, and participation in hospital issues were negative predictors for adverse events related to the patient, while postoperative nurse care was a positive predictor. CONCLUSION there is an increase in adverse events when nurses are dissatisfied at work, less professional commitment and low availability to participate in the subjects of their unit. On the other hand, adverse events decrease when nurses perform the care in the postoperative period. Satisfaction was good and there was no association with the characteristics of nurses' attention. It is recommended to improve these predictors to increase the safety of surgical patients.
Collapse
|
33
|
Agarwal N, Faramand A, Bellon J, Borrebach J, Hamilton DK, Okonkwo DO, Kanter AS. Limitations of patient experience reports to evaluate physician quality in spine surgery: analysis of 7485 surveys. J Neurosurg Spine 2019; 30:520-523. [PMID: 30641854 DOI: 10.3171/2018.8.spine18104] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 08/29/2018] [Indexed: 01/20/2023]
Abstract
OBJECTIVE The Clinician and Group Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) is a standardized patient experience survey that is used to evaluate the quality of care delivered by physicians. The authors sought to determine which factors influenced CG-CAHPS scores for spine surgery, and compare them to their cranial-focused cohorts. METHODS A retrospective study of prospectively obtained data was performed to evaluate CG-CAHPS scores. Between May 2013 and May 2017, all patients 18 years of age or older with an outpatient encounter with a neurosurgeon (5 spine-focused neurosurgeons and 20 cranial-focused neurosurgeons) received a CG-CAHPS survey. Three domains were assessed: overall physician rating, likelihood to recommend, and physician communication. Statistical analyses were performed using chi-square tests. RESULTS Seven thousand four hundred eighty-five patient surveys (2319 spine and 5166 cranial) were collected from patients presenting to the outpatient offices of an attending neurosurgeon. Analysis of the overall physician rating showed that 81.1% of spine neurosurgeons received a "top-box" score (answers of "yes, definitely"), whereas 86.2% of cranial neurosurgeons received a top-box response (p < 0.001). A similar difference was observed with the domains of "likelihood to recommend" and "physician communication." Overall physician rating was also significantly influenced by the general and mental health of the patients surveyed (p < 0.001). For spine surgeons seeing patients at more than one facility, the scores with respect to location were also significantly different in all domains for each individual provider (p < 0.001). CONCLUSIONS Overall, spine-focused neurosurgeon ratings differed significantly from those of cranial-focused neurosurgical subspecialty providers. Office location also affected provider ratings for spine neurosurgeons. These results suggest that physician ratings obtained via patient experience surveys may be representative of factors aside from just the quality of physician care provided. This information should be considered as payers, government, and health systems design performance programs based on patient experience scores.
Collapse
Affiliation(s)
| | | | - Johanna Bellon
- 2Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Jeffrey Borrebach
- 2Wolff Center, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | | | | | | |
Collapse
|
34
|
Peng DX, Ye Y, Feng B, Ding DX, Heim GR. Impacts of Hospital Complexity on Experiential Quality: Mitigating Roles of Information Technology. DECISION SCIENCES 2019. [DOI: 10.1111/deci.12368] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- David Xiaosong Peng
- C. T. Bauer College of BusinessDepartment of Decision and Information SciencesUniversity of Houston Houston TX 77204‐6021
| | - Yuan Ye
- College of Business AdministrationCalifornia State University Sacramento CA 95819
| | - Bo Feng
- Dongwu Business SchoolSoochow University Suzhou China 215006
| | - David Xin Ding
- Department of Supply Chain ManagementRutgers Business School–Newark and New Brunswick Newark NJ 07102
| | - Gregory R. Heim
- Department of Information and Operations Management, Mays Business SchoolTexas A&M University, College Station TX 77843‐4217
| |
Collapse
|
35
|
Ke P, Jiang F, Wu D, Ke L, Lin Z, Jia J, Ye B, Liu B. A third-party investigation of inpatient satisfaction with a tertiary hospital in People's Republic of China. Patient Prefer Adherence 2018; 12:2027-2037. [PMID: 30349199 PMCID: PMC6188104 DOI: 10.2147/ppa.s176471] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Conflicts between doctors and patients occur in People's Republic of China each year. Serious negative relationships between doctors and patients are a significant social problem. This study aims to evaluate the satisfaction of inpatients in a tertiary hospital through a third party and analyze the relationship between sociodemographic characteristics and overall satisfaction. PATIENTS AND METHODS A cross-sectional investigation was conducted to obtain the demographic information and results for 20 items in an inpatient satisfaction questionnaire. A total of 872 inpatients were studied. Descriptive analysis was conducted using SPSS version 22.0 software. Independent sample t-tests and one-way ANOVA were used to compare the mean differences between groups. Multiple linear regression analysis was conducted to study the relationship between different demographic characteristics and overall satisfaction. P-values of <0.05 were considered significant. Matrix analysis was used to predict which of the 20 items had a higher priority for patient satisfaction. RESULTS Among the respondents, valid questionnaires were completed by 872 patients, with a response rate of 94.47% (872/923). The hospital inpatient satisfaction score was 84.92±10.34. Among the sociodemographic characteristics, education status, occupation, annual income, residence and frequency of visits were related to inpatient satisfaction and were statistically significant (P<0.05). However, sex, age and marital status were not significantly different in terms of the inpatient satisfaction score (P>0.05). Multiple linear regression analysis results showed that residence, age, occupation and education status were the factors affecting inpatient satisfaction. In further analyses, diet management, medical expenses, complaint management and hospital environment were in urgent need of improvement. CONCLUSION The overall level of inpatient satisfaction with this hospital seems to be acceptable, although areas for improvement remain.
Collapse
Affiliation(s)
- Pan Ke
- Health Management and Health Development Research Center of Hubei University of Medicine, Shiyan, People's Republic of China,
| | - Fengbo Jiang
- Postgraduate Training Base of Hubei University of Medicine, Jinzhou Medical University, Jinzhou, People's Republic of China
| | - Dongmei Wu
- Department of Cardiology Three Wards, Shiyan Taihe Hospital (The Affiliated Hospital of Hubei University of Medicine), Shiyan, People's Republic of China
| | - Li Ke
- Postgraduate Training Base of Hubei University of Medicine, Jinzhou Medical University, Jinzhou, People's Republic of China
| | - Zi Lin
- Postgraduate Training Base of Hubei University of Medicine, Jinzhou Medical University, Jinzhou, People's Republic of China
| | - Jia Jia
- Postgraduate Training Base of Hubei University of Medicine, Jinzhou Medical University, Jinzhou, People's Republic of China
| | - Baoxia Ye
- Department of Cardiology Three Wards, Shiyan Taihe Hospital (The Affiliated Hospital of Hubei University of Medicine), Shiyan, People's Republic of China
| | - Bing Liu
- Health Management and Health Development Research Center of Hubei University of Medicine, Shiyan, People's Republic of China,
| |
Collapse
|