Barr Judith K, Bernard Shulamit L, Sofaer Shoshanna, Giannotti Tierney E, Lenfestey Nancy F, Miranda David J
Qualidigm.
Med Care Res Rev. 2008 Dec;65(6):655-73. doi: 10.1177/1077558708319734. Epub 2008 Jul 2.
This article describes physicians' responses to patient questions and physicians' views about public reports on hospital quality. Interviews with 56 office-based physicians in seven states/regions used hypothetical scenarios of patients questioning referrals based on public reports of hospital quality. Responses were analyzed using an iterative coding process to develop categories and themes from data. Four themes describe physicians' responses to patients: (a) rely on existing physician-patient relationships, (b) acknowledge and consider patient perspectives, (c) take actions to follow up on patient concerns, and (d) provide patients' perspectives on quality reports. Three themes summarize responses to hospital quality reports: perceived lack of methodological rigor, content considerations in reports, and attitudes/experience regarding reports. Findings suggest that physicians take seriously patients' questions about hospital-quality reports and consider changing referral recommendations based on their concerns and/or preferences. Results underscore the importance of efforts by report developers and physician outreach/education to address physicians' methodological concerns.
本文描述了医生对患者问题的回应以及医生对医院质量公开报告的看法。对七个州/地区的56名门诊医生进行了访谈，采用了基于医院质量公开报告的患者质疑转诊的假设情景。通过迭代编码过程对回复进行分析，以便从数据中提炼出类别和主题。四个主题描述了医生对患者的回应：（a）依赖现有的医患关系，（b）承认并考虑患者观点，（c）采取行动跟进患者关切的问题，以及（d）提供患者对质量报告的看法。三个主题总结了对医院质量报告的回应：认为缺乏方法严谨性、报告中的内容考量以及对报告的态度/经验。研究结果表明，医生认真对待患者关于医院质量报告的问题，并考虑根据患者的关切和/或偏好改变转诊建议。结果强调了报告编制者以及医生宣传/教育工作解决医生方法学担忧的重要性。
