Sheba Medical Center, Tel Hashomer, Israel.
Isr J Health Policy Res. 2013 Sep 17;2(1):35. doi: 10.1186/2045-4015-2-35.
Patient-centered care has become an increasing priority in the United States and plays a prominent role in recent healthcare reforms. One way the country has managed to advance patient-centered care is through establishment of a family of national patient experience surveys (the Consumer Assessment of Healthcare Providers and Systems Plans (CAHPS). CAHPS is publicly reported for several types of providers and was recently tied to hospital reimbursement. This is part of a trend over the last two decades that has shifted provider-patient relationships from a traditional paternal approach to customer service and then to clinical partnership. The health care system in Israel, however, is still struggling to overcome barriers to change in this area. While community based biannual patient experience surveys are conducted by the Myers-JDC-Brookdale Institute, there is no comprehensive national approach to measuring the patient experience across a broad range of settings. Only recently did the Israeli Ministry of Health take its first steps to include patient experience as a dimension of health care quality.In its current position, Israel should learn from the U.S. experience with policies promoting patient-centered care, and specifically the impact on clinical services of measuring the patient experience. Looking at what has happened in the United States, we suggest three main lessons. First, there is a need for a set of national patient experience surveys that would be publicly reported and eventually tied to provider reimbursement. Secondly, the national survey tools should be customized to the unique characteristics of Israeli society and draw from recent research on patient-centeredness to include new and important domains such as patient activation and shared decision-making. Finally, newer technological approaches should be explored with the aim of increasing response rates and the timeliness and usefulness of the surveys.
以患者为中心的护理在美国已成为日益优先考虑的事项，并在最近的医疗改革中发挥了重要作用。美国推进以患者为中心的护理的方法之一是建立了一系列国家患者体验调查（医疗保健提供者和系统计划的消费者评估 (CAHPS)）。CAHPS 针对多种类型的提供者进行了公开报告，并最近与医院报销挂钩。这是过去二十年来的一种趋势的一部分，这种趋势将医患关系从传统的家长式方法转变为客户服务，然后转变为临床合作伙伴关系。然而，以色列的医疗体系仍在努力克服在这一领域变革的障碍。虽然 Myers-JDC-Brookdale 研究所每两年进行一次基于社区的患者体验调查，但以色列没有全面的国家方法来衡量广泛的环境中的患者体验。直到最近，以色列卫生部才首次采取措施将患者体验作为医疗质量的一个维度纳入其中。在当前的情况下，以色列应该从美国推行以患者为中心的护理政策的经验中吸取教训，特别是衡量患者体验对临床服务的影响。从美国的情况来看，我们提出了三个主要的经验教训。首先，需要建立一套国家患者体验调查，这些调查将公开报告，并最终与提供者的报销挂钩。其次，国家调查工具应根据以色列社会的独特特点进行定制，并借鉴最近关于以患者为中心的研究，包括新的和重要的领域，如患者激活和共同决策。最后，应该探索更新的技术方法，以提高调查的回应率、及时性和有用性。
