School of Nursing George Washington University, Washington, DC, USA.
Health Aff (Millwood). 2013 Jul;32(7):1299-305. doi: 10.1377/hlthaff.2012.1409.
Measures of the patient care experience are now routinely used in public reports and increasingly influence health provider payment. We examined data from 5,002 patients of forty-nine primary care providers to explore the relationship between patient activation-a term referring to the knowledge, skills, and confidence a patient has for managing his or her health care-and the patient care experience. We found that patients at higher levels of activation had more positive experiences than patients at lower levels seeing the same clinician. The observed differential was maintained when we controlled for demographic characteristics and health status. We did not find evidence that patients at higher levels of activation selected providers who were more patient-centric. The findings suggest that the care experience is transactional, shaped by both providers and patients. Strategies to improve the patient experience, therefore, should focus not only on providers but also on improving patients' ability to elicit what they need from their providers.
患者护理体验的衡量标准现在已被常规用于公共报告中，并越来越多地影响医疗服务提供者的支付。我们分析了 49 名初级保健提供者的 5002 名患者的数据，以探讨患者激活水平（该术语是指患者管理其医疗保健的知识、技能和信心）与患者护理体验之间的关系。我们发现，与接受同一位临床医生治疗的低激活水平患者相比，高激活水平患者的体验更积极。当我们控制人口统计学特征和健康状况时，观察到的差异仍然存在。我们没有发现证据表明，高激活水平的患者选择了更以患者为中心的提供者。研究结果表明，护理体验是一种交互作用，既受到提供者的影响，也受到患者的影响。因此，改善患者体验的策略不仅应关注提供者，还应关注提高患者从提供者那里获得所需服务的能力。
