Department of Public Health, University of Oxford, UK.
J Health Serv Res Policy. 2013 Jan;18(1):28-33. doi: 10.1258/jhsrp.2012.011176.
To investigate patients' experiences of health and social care services in long-term neurological conditions in England.
Cross-sectional survey of 5209 patient members of the Motor Neurone Disease Association (MND, n = 890), Multiple Sclerosis Society (MS, n = 2345) or Parkinson's UK (PD, n = 1974). A questionnaire on patient experiences of health and social care was completed by 2563 (49%) (505 MND, 1157 MS and 901 PD).
A mixed picture of experiences of health and social care in MND, MS or PD was found with few problems reported for some aspects of services such as obtaining information about medication (n = 117, 6.1%). In contrast, problems with planning and integration of care were reported frequently, with 78.0% of patients not having a care plan and 61.9% reporting that services do not collaborate well in planning care. Other problems included delays with diagnosis, information about medication side effects, and management of conditions whilst in hospital. Significant differences between the three conditions were found for most aspects of care, with MND patients generally reporting fewer problems. The findings highlight which areas of health and social care need to be improved and monitored. While a larger sample size was obtained than in other studies, possible limitations include the sampling frame and the 49% response rate.
Planning and integration of care are key areas that require improvement.
调查英国长期神经状况患者对卫生和社会保健服务的体验。
横断面调查英格兰肌萎缩侧索硬化症协会(MND,n=890)、多发性硬化症协会(MS,n=2345)或帕金森氏症协会(PD,n=1974)的 5209 名患者会员。2563 名(49%)(505 名 MND、1157 名 MS 和 901 名 PD)患者完成了一份关于健康和社会保健体验的问卷。
在 MND、MS 或 PD 中,发现卫生和社会保健体验呈现出好坏参半的情况,一些服务方面的问题报告很少,例如获取有关药物的信息(n=117,6.1%)。相比之下,规划和整合护理方面的问题经常被报告,78.0%的患者没有护理计划,61.9%的患者报告服务在规划护理方面协作不佳。其他问题包括诊断延迟、药物副作用信息以及在医院管理病情。在大多数护理方面,三种情况之间存在显著差异,MND 患者一般报告的问题较少。研究结果突出了需要改进和监测的卫生和社会保健领域。虽然比其他研究获得了更大的样本量,但可能存在的局限性包括抽样框架和 49%的回复率。
护理的规划和整合是需要改进的关键领域。