Sizmur Steve, Graham Chris, Walsh Joan
Survey Statistician, Picker Institute Europe, Oxford, UK
Survey Statistician, Picker Institute Europe, Oxford, UK.
J Health Serv Res Policy. 2015 Jan;20(1):5-10. doi: 10.1177/1355819614536887. Epub 2014 Jun 27.
To investigate the impact of demographic factors (patients' age and sex) and of the mode of administration of a national patient experience questionnaire in England: the NHS Friends and Family Test.
Secondary analysis of April-August 2013 data collected using a mixed mode approach from 38,998 inpatients and 29,610 emergency department attendees at 429 wards or units in 32 hospitals. Multilevel models were applied with responses from wards nested within hospitals and trusts. Age, sex and mode of administration were entered as main effects.
There were consistent differences in response for patients and emergency department attendees related to their age and sex. Women gave less positive ratings than men, whilst the likelihood of positive responses increased with age except among the oldest age group (75 years and above). As regards mode of administration, online responses were significantly less positive than postcard responses: the mean differences in score were 22.0 points for inpatients (95% confidence interval 27.3 to 16.7) and 18.0 points for emergency department attendees (29.0 to 7.0). Telephone responses were significantly more positive than postcard responses, with a mean difference of 9.2 (1.6-16.8) in the emergency department setting.
Data from the Friends and Family Test are vulnerable to bias from demographic factors and from the mode of administration. Comparisons between organisations should be avoided. Scores may be useful at a local level where the test is implemented consistently and patients' demographic characteristics remain stable. Improving the utility of the Friends and Family Test nationally requires a standardised method for administration and adjustment of results for demographic characteristics.
调查人口统计学因素（患者年龄和性别）以及英国国家患者体验调查问卷（国民保健服务机构的朋友和家人测试）的管理模式所产生的影响。
对2013年4月至8月的数据进行二次分析，这些数据是采用混合模式方法从32家医院的429个病房或科室的38998名住院患者和29,610名急诊科就诊者中收集的。应用多水平模型，病房的回答嵌套在医院和信托机构中。年龄、性别和管理模式作为主要影响因素纳入。
患者和急诊科就诊者的回答在年龄和性别方面存在一致差异。女性给出的积极评价低于男性，而除最年长年龄组（75岁及以上）外，积极回答的可能性随年龄增加而增加。至于管理模式，在线回答的积极性明显低于明信片回答：住院患者得分的平均差异为22.0分（95%置信区间27.3至16.7），急诊科就诊者为18.0分（29.0至7.0）。电话回答的积极性明显高于明信片回答，在急诊科环境中平均差异为9.2（1.6 - 16.8）。
朋友和家人测试的数据容易受到人口统计学因素和管理模式偏差的影响。应避免组织之间的比较。在测试实施一致且患者人口统计学特征保持稳定的地方层面，分数可能有用。在全国范围内提高朋友和家人测试的效用需要一种标准化的管理方法以及针对人口统计学特征对结果进行调整。
