Department of Primary Care and Public Health Sciences, King's College London, London, UK.
J Health Serv Res Policy. 2012 Jul;17(3):181-7. doi: 10.1258/JHSRP.2012.011122.
To explore patients' perceptions of events that may represent errors in long-term illness care and evaluate potential associations with dimensions of quality in health care.
Qualitative study based on semi-structured interviews with 33 patients with long-term conditions.
Patients' accounts revealed experiences of errors arising from health care. Errors of access included difficulties of gate-keeping leading to problems in gaining access to primary care consultations, diagnostic tests and specialist care. Potential harms included delayed diagnosis or delayed delivery of specialist care. Errors of interpersonal care included patients' perceptions of not being taken seriously, including perceived failure by professionals to respond adequately to reports of adverse drug reactions or accounts of painful symptoms. Potential harms included continuing medication-related symptoms, negative emotional reactions and breakdown in communication between patients and professionals. Errors were noted at transitions between primary and secondary care including failures of information transfer and communication.
Problems of gaining access to care and problems at transitions between levels of care may sometimes constitute errors, but they may also give rise to circumstances in which errors occur. Interpersonal and communication problems may also be associated with errors. There appears to be a close relationship between broader concepts of quality of care and the concept of patient safety.
探索患者对长期疾病护理中可能出现的错误事件的看法，并评估其与医疗保健质量维度的潜在关联。
基于对 33 名长期患病患者的半结构化访谈的定性研究。
患者的叙述揭示了医疗保健中出现错误的经历。获取方面的错误包括守门人制度导致患者在获得初级保健咨询、诊断测试和专科护理方面出现问题。潜在危害包括延迟诊断或延迟提供专科护理。人际护理方面的错误包括患者感到自己不被重视，包括专业人员对不良反应报告或痛苦症状的描述没有做出适当的反应。潜在危害包括持续的药物相关症状、负面情绪反应以及患者和专业人员之间的沟通破裂。在初级保健和二级保健之间的过渡中也出现了问题，包括信息传递和沟通的失败。
获得医疗保健的机会和在医疗保健水平之间过渡的问题有时可能构成错误，但也可能导致错误发生的情况。人际和沟通问题也可能与错误有关。在更广泛的医疗保健质量概念和患者安全概念之间似乎存在密切的关系。
