Montini Theresa, Noble Alice A, Stelfox Henry Thomas
Department of Cardiology and Comprehensive Care, New York University College of Dentistry, New York, NY, USA.
Int J Qual Health Care. 2008 Dec;20(6):412-20. doi: 10.1093/intqhc/mzn041. Epub 2008 Sep 17.
To develop a standard taxonomy for inpatient complaints that could be adopted in a wide array of health service institutions.
A taxonomy was developed by merging the coding schemes from eight prior studies of patient complaints, and then by revising the received coding scheme in light of the codes and clarifications that emerged from a content analysis of patient complaints.
Two Boston area hospitals.
Stratified random sample of 1216 complaints from patients in 2004.
s) None. Main outcome measure(s) Patient complaints codes, provider codes and inter-rater reliability.
A taxonomy comprising 22 patient complaint codes and five provider codes was developed. Inter-rater agreement for complaint codes was good (median Kappa statistic 0.66, interquartile range 0.55-0.80). Four codes were each used in more than 10% of the patient complaints filed: unprofessional conduct (19%); poor provider-patient communication (17%); treatment and care of patient (16%); and, having to wait for care (11%). Of the coding for the profession of the person complained about, 47% of the patient complaints were about staff in general or did not specify a particular profession; 22% identified a physician or dentist; 12% nursing staff; 11% administrative or support staff and 8% allied clinical health professionals.
Standardized coding of patient complaint data may provide an opportunity for quality improvement, patient satisfaction and changes in patient care.
制定一种可在众多卫生服务机构采用的住院患者投诉标准分类法。
通过合并先前八项患者投诉研究的编码方案，然后根据对患者投诉进行内容分析得出的编码和说明对所得编码方案进行修订，从而制定出一种分类法。
波士顿地区的两家医院。
2004年从患者中抽取的1216份投诉的分层随机样本。
无。主要结局指标：患者投诉编码、提供者编码及评分者间信度。
制定出了一种包含22个患者投诉编码和5个提供者编码的分类法。投诉编码的评分者间一致性良好（中位数Kappa统计量为0.66，四分位间距为0.55 - 0.80）。有四个编码在超过10%的患者投诉中被使用：不专业行为（19%）；医患沟通不良（17%）；患者的治疗与护理（16%）；以及等待护理（11%）。在对被投诉者职业的编码中，47%的患者投诉针对的是一般工作人员或未指明特定职业；22%指明是医生或牙医；12%是护理人员；11%是行政或辅助人员；8%是临床 allied 健康专业人员。
患者投诉数据的标准化编码可能为质量改进、患者满意度及患者护理的改变提供契机。
