Taylor David McD, Wolfe Rory S, Cameron Peter A
Emergency Department, Royal Melbourne Hospital, and Department of Epidemiology and Preventive Medicine, Monash University, Parkville, VIC 3050.
Med J Aust. 2004 Jul 5;181(1):31-5. doi: 10.5694/j.1326-5377.2004.tb06157.x.
To describe complaints by patients and compare rates of complaint in demographic subgroups of patients and hospital departments.
Retrospective analysis of complaints made by patients attending 67 hospitals (metropolitan, 25; rural, 42) in Victoria, and lodged with the Victorian Health Complaint Information Program (January 1997 - December 2001).
Demographic characteristics of patients lodging complaints and the hospital department involved; nature and outcome of complaints.
From a total of over 13 million patients presenting to hospital during the study period, 19 156 patients or their representatives (mostly their parents, children or spouses) lodged 26 785 "issues" of complaint (overall complaint rate, 1.42 complaints/1000 patients). Significantly more complaints (P < 0.001) were lodged by (or on behalf of) female patients (complaint rate ratio, 1.3; 95% CI, 1.2-1.3), public patients (rate ratio, 2.1; 95% CI, 2.0-2.2) and Australian-born patients (rate ratio, 8.9; 95% CI, 8.3-9.6). The complaint rate for general wards was 6.2/1000 patients (95% CI, 6.1-6.3). Intensive care units had a similar rate of 5.9/1000 (95% CI, 5.4-6.5), but aged-care departments had a significantly higher rate of 45.2/1000 (95% CI, 39.5-51.7), while emergency departments (1.9/1000; 95% CI, 1.8-2.0), operating theatres (1.0/1000; 95% CI, 1.0-1.1), day-procedure units (0.5/1000; 95% CI, 0.5-0.6) and outpatient departments (0.4/1000; 95% CI, 0.4-0.4) had significantly lower rates. Complaints relating to communication (poor attention, discourtesy, rudeness), access to healthcare (no/inadequate service, treatment delays) and treatment (inadequate treatment and nursing care) accounted for 29.2%, 28.5% and 22.5% of complaints, respectively. Most (84.5%) complaints were resolved. Apologies or explanations resolved 27.8% and 27.5% of complaints, respectively.
Interventions to decrease the number of complaints in the areas of communication and access to healthcare need to be implemented. The active use of complaint data for quality-improvement activities is recommended.
描述患者的投诉情况,并比较不同人口统计学亚组患者及医院科室的投诉率。
对维多利亚州67家医院(25家都市医院,42家乡村医院)的患者投诉进行回顾性分析,这些投诉已提交至维多利亚州健康投诉信息项目(1997年1月至2001年12月)。
提出投诉的患者的人口统计学特征及相关医院科室;投诉的性质及结果。
在研究期间,共有超过1300万名患者到医院就诊,其中19156名患者或其代表(大多数为其父母、子女或配偶)提出了26785项“投诉问题”(总体投诉率为1.42起投诉/1000名患者)。女性患者(投诉率比为1.3;95%置信区间为1.2 - 1.3)、公立患者(投诉率比为2.1;95%置信区间为2.0 - 2.2)以及在澳大利亚出生的患者(投诉率比为8.9;95%置信区间为8.3 - 9.6)提出的投诉显著更多(P < 0.001)。普通病房的投诉率为6.2起/1000名患者(95%置信区间为6.1 - 6.3)。重症监护病房的投诉率与之相近,为5.9起/1000名患者(95%置信区间为5.4 - 6.5),但老年护理科室的投诉率显著更高,为45.2起/1000名患者(95%置信区间为39.5 - 51.7),而急诊科(1.9起/1000名患者;95%置信区间为1.8 - 2.0)、手术室(1.0起/1000名患者;95%置信区间为1.0 - 1.1)、日间手术科室(0.5起/1000名患者;95%置信区间为0.5 - 0.6)和门诊部(0.4起/1000名患者;95%置信区间为0.4 - 0.4)的投诉率则显著更低。与沟通(关注不足、无礼、粗鲁)、获得医疗服务(无/服务不足、治疗延误)和治疗(治疗及护理不足)相关的投诉分别占投诉总数的29.2%、28.5%和22.5%。大多数(84.5%)投诉得到了解决。道歉或解释分别解决了27.8%和27.5%的投诉。
需要采取干预措施以减少沟通和获得医疗服务方面的投诉数量。建议积极利用投诉数据开展质量改进活动。