Centre for Health Policy, Institute for Global Health Innovation, Imperial College London, UK.
Centre for Health Policy, Institute for Global Health Innovation, Imperial College London, UK.
Soc Sci Med. 2013 Dec;99:27-34. doi: 10.1016/j.socscimed.2013.09.027. Epub 2013 Oct 8.
Quality continues to be placed at the heart of discussions about healthcare. This raises important questions about precisely what quality care is, and how it should be measured. An overall measure of subjective well-being (SWB) that assesses and joins up different stages of the treatment process, and the different people affected, could potentially be used to capture the full impact of quality care throughout the entire treatment process. This article presents a temporal model through which SWB links all stages in the treatment and care process, thus allowing the overall quality of care to be determined and valued according to its direct effect on people's lives. Drawing on existing medical and behavioural studies, we populate this model with evidence that demonstrates how SWB is affected at different points along the patient pathway. SWB is shown to have an effect on outcomes at all stages of the treatment experience and improved health and quality outcomes are shown to consistently enhance SWB. Furthermore, SWB measures are shown to be a suitable method to value the impact of healthcare on the families and carers of patients and, in this way, can join up health outcomes to show wider effects of treatment on patients' lives. Measuring an individual's SWB throughout his or her treatment experience can enable a full appraisal of the quality of care that they receive. This will facilitate service improvements at the micro level and help value treatments for resource allocation purposes at the macro level.
质量一直是医疗保健讨论的核心。这就提出了一些重要的问题，即什么是高质量的医疗保健，以及如何衡量它。一个全面的主观幸福感（SWB）衡量标准，可以评估和整合治疗过程的不同阶段以及受影响的不同人群，有可能被用来捕捉整个治疗过程中高质量医疗保健的全部影响。本文提出了一个时间模型，通过该模型，SWB 将治疗和护理过程的所有阶段联系起来，从而可以根据其对人们生活的直接影响来确定和评估整体护理质量。本文利用现有的医学和行为研究，用证据填充了这个模型，证明了 SWB 在患者治疗路径的不同点是如何受到影响的。研究表明，SWB 对治疗体验各个阶段的结果都有影响，改善健康和提高生活质量会持续提高 SWB。此外，研究表明，SWB 衡量标准是一种合适的方法，可以衡量医疗保健对患者家属和照顾者的影响，从而可以将健康结果与治疗对患者生活的更广泛影响联系起来。在患者的整个治疗过程中衡量其 SWB，可以全面评估他们所接受的医疗保健质量。这将有助于在微观层面上改进服务，并有助于在宏观层面上为资源分配目的评估治疗效果。
