对英国医院护理患者评价的混合方法分析：对美国医疗质量数据公开报告的启示。

A mixed-methods analysis of patient reviews of hospital care in England: implications for public reporting of health care quality data in the United States.

作者信息

Lagu Tara, Goff Sarah L, Hannon Nicholas S, Shatz Amy, Lindenauer Peter K

机构信息

Center for Quality of Care Research, Baystate Medical Center, Springfield, MA, USA.

出版信息

Jt Comm J Qual Patient Saf. 2013 Jan;39(1):7-15. doi: 10.1016/s1553-7250(13)39003-5.

DOI:10.1016/s1553-7250(13)39003-5

PMID:23367647

Abstract

BACKGROUND

In the United States patients have limited opportunities to read and write narrative reviews about hospitals. In contrast, the National Health Service (NHS) in England encourages patients to provide feedback to hospitals on their quality-reporting website, NHS Choices. The scope and content of the narrative feedback was studied.

METHODS

All NHS hospitals with more than 10 reviews posted on NHS Choices were included in a cross-sectional mixed-methods (qualitative and quantitative) analysis of patients' reviews of 20 randomly selected hospitals.

RESULTS

The final sample consisted of 264 hospitals and 2,640 patient responses to structured questions. All 200 reviews from the 20 hospitals randomly selected were subjected to further quantitative and qualitative analysis. Comments about clinicians and staff were common (179 [90%]) and overwhelmingly positive, with 149 (83%) favorable to workers. In 124 (62%) of the 200 reviews, patients commented on technical aspects of hospital care, including quality of care, injuries, errors, and incorrect medical record or discharge documentation. Perceived medical errors were described in 51 (26%) hospital reviews. Comments about the hospital facility appeared in half (52%) of reviews, describing hospital cleanliness, food, parking, and amenities. Hospitals replied to 56% of the patient reviews.

DISCUSSION

NHS Choices represents the first government-run initiative that enables any patient to provide narrative feedback about hospital care. Reviews appear to have similar domains to those covered in existing satisfaction surveys but also include detailed feedback that would be unlikely to be revealed by such surveys. Online narrative reviews can therefore provide useful and complementary information to consumers (patients) and hospitals, particularly when combined with systematically collected patient experience data.

摘要

背景

在美国，患者撰写关于医院的叙述性评价的机会有限。相比之下，英国国家医疗服务体系（NHS）鼓励患者在其质量报告网站“NHS选择”上向医院提供反馈。本研究对叙述性反馈的范围和内容进行了探究。

方法

对“NHS选择”网站上发布了10条以上评价的所有NHS医院进行横断面混合方法（定性和定量）分析，这些评价来自随机选取的20家医院的患者。

结果

最终样本包括264家医院以及2640份患者对结构化问题的回答。对随机选取的20家医院的全部200条评价进行了进一步的定量和定性分析。关于临床医生和工作人员的评价很常见（179条[90%]），且绝大多数是积极的，其中149条（83%）对工作人员表示赞许。在200条评价中的124条（62%）里，患者对医院护理的技术方面发表了评论，包括护理质量、受伤情况、失误以及不正确的病历或出院文件。51条（26%）医院评价中提到了感知到的医疗失误。关于医院设施的评论出现在一半（52%）的评价中，内容涉及医院清洁度、食物、停车和便利设施。医院回复了56%的患者评价。