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选择手术医院:关注医疗质量信息的重要性。

Choosing a hospital for surgery: the importance of information on quality of care.

机构信息

Department of Medical Decision Making, Leiden University Medical Center, Leiden, The Netherlands.

出版信息

Med Decis Making. 2010 Sep-Oct;30(5):544-55. doi: 10.1177/0272989X09357474. Epub 2010 Jan 28.

Abstract

OBJECTIVE

To assess whether patients use information on quality of care when choosing a hospital for surgery compared with more general hospital information.

METHODS

In this cross-sectional study in 3 Dutch hospitals, questionnaires were sent to 2122 patients who underwent 1 of 6 elective surgical procedures in 2005-2006 (aorta reconstruction [for treatment of aneurysm], cholecystectomy, colon resection, inguinal hernia repair, esophageal resection, thyroid surgery). Patients were asked which information they had used to choose this hospital and which information they intended to use if they would need similar surgical treatment in the future.

RESULTS

In total, 1329 questionnaires were available for analysis (response rate 62.6%). Most patients indicated having used the hospital's good reputation (69.1%) and friendly hospital atmosphere (63.3%) to choose a hospital. For future choices, most patients intended to use the fact that they were already treated in that hospital (79.3%) and the hospital's good reputation (74.1%). Regarding quality-of-care information, patients preferred a summary measure (% patients with ''textbook outcome'') over separate more detailed measures (52.1% v. 38.0%, χ2 = 291, P < 0.01). For future choices, patients intend to use more information items than in 2005-2006, both in absolute terms (9 v. 4 items, t = 38.3, P < 0.01) as relative to the total number of available items (41.3% [40.1%-42.5%] v. 29.2% [28.1%-30.2%]).

CONCLUSION

Patients intended to use more information for future choices than they used for past choices. For future choices, most patients prefer a summary measure on quality of care over more detailed measures but seem to value that they were already treated in that hospital or a hospital's good reputation even more.

摘要

目的

评估患者在选择手术医院时是否会使用有关医疗质量的信息,而不是更一般的医院信息。

方法

在这项 2005-2006 年在荷兰 3 家医院进行的横断面研究中,向 2122 名接受 6 种择期手术之一的患者(主动脉重建术[用于治疗动脉瘤]、胆囊切除术、结肠切除术、腹股沟疝修补术、食管切除术、甲状腺手术)发送了问卷。患者被要求回答他们使用了哪些信息来选择这家医院,如果将来需要类似的手术治疗,他们打算使用哪些信息。

结果

共有 1329 份问卷可供分析(应答率为 62.6%)。大多数患者表示选择医院时使用了医院的良好声誉(69.1%)和友好的医院氛围(63.3%)。对于未来的选择,大多数患者打算使用他们已经在该医院接受治疗的事实(79.3%)和医院的良好声誉(74.1%)。关于医疗质量信息,患者更喜欢综合衡量标准(%有“教科书式结果”的患者)而不是更详细的单独衡量标准(52.1%比 38.0%,χ2=291,P<0.01)。对于未来的选择,患者打算使用比 2005-2006 年更多的信息项目,无论是绝对值(9 个比 4 个项目,t=38.3,P<0.01)还是相对于可用项目总数(41.3%[40.1%-42.5%]比 29.2%[28.1%-30.2%])。

结论

患者打算在未来选择中使用比过去选择更多的信息。对于未来的选择,大多数患者更喜欢医疗质量的综合衡量标准而不是更详细的衡量标准,但似乎更看重他们已经在该医院接受过治疗或医院的良好声誉。

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