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患者与医生对炎症性肠病护理质量的看法:来自前瞻性IG-IBD研究SOLUTION-1的结果

Patient and physician views on the quality of care in inflammatory bowel disease: results from SOLUTION-1, a prospective IG-IBD study.

作者信息

Bortoli Aurora, Daperno Marco, Kohn Anna, Politi Patrizia, Marconi Stefano, Monterubbianesi Rita, Castiglione Fabiana, Corbellini Ada, Merli Manuela, Casella Giovanni, D'Incà Renata, Orlando Ambrogio, Bossa Fabrizio, Doldo Patrizia, Lecis Pierenrico, Valpiani Daniela, Danese Silvio, Comberlato Michele

机构信息

Department of Gastroenterology and Digestive Endoscopy, A.O.G.Salvini, Rho Hospital, Italy.

Gastroenterology Unit, A.O. Ordine Mauriziano, Turin, Italy.

出版信息

J Crohns Colitis. 2014 Dec;8(12):1642-52. doi: 10.1016/j.crohns.2014.07.004. Epub 2014 Aug 10.

Abstract

INTRODUCTION

Remarkable differences in quality of care (QoC) might be observed in different countries, affecting quality of life of inflammatory bowel disease (IBD) patients. The aim of this study was to assess patient and physician perceptions of the QoC in Italy.

METHODS

A multicentre observational study on the quality of care in IBD (SOLUTION-1) was conducted in 36 IG-IBD (Italian Group for Inflammatory Bowel Disease) centres in Italy. The QUOTE-IBD (Quality of Care Through the Patient's Eyes) questionnaire was administered to IBD patients and to the attending physicians. The Quality Impact (QI) score summarises the QUOTE-IBD questionnaire, and a QI >9 is considered satisfactory.

RESULTS

Nine-hundred-ninety-two patients and 75 physicians completed the QUOTE-IBD questionnaire. The patients scored the domains of competence (9.47 vs. 8.55) and costs (9.54 vs. 8.26) higher that the physicians, while information (9.31 vs. 9.43) and continuity of care (8.40 vs. 9.01) were scored lower. The QI score was rated worse by physicians with less experience (<12 years) with regard to competence (8.0 vs. 9.01), courtesy (8.12 vs. 10.0) and autonomy (8.97 vs. 10.0). Physicians considered the cost domain unsatisfactory.

CONCLUSIONS

Healthcare was rated as satisfactory overall for Italian patients and physicians. The physicians underestimate their competence and consider the cost of medical management unsatisfactory. The patients are more critical regarding the continuity of care and information. Country-specific data on QoC allow local governments to allocate resources more effectively.

摘要

引言

不同国家在医疗质量(QoC)方面可能存在显著差异,这会影响炎症性肠病(IBD)患者的生活质量。本研究旨在评估意大利患者和医生对医疗质量的看法。

方法

在意大利的36个IG-IBD(意大利炎症性肠病小组)中心进行了一项关于IBD医疗质量的多中心观察性研究(SOLUTION-1)。向IBD患者和主治医生发放了“通过患者视角看医疗质量”(QUOTE-IBD)问卷。质量影响(QI)评分汇总了QUOTE-IBD问卷,QI>9被认为是令人满意的。

结果

992名患者和75名医生完成了QUOTE-IBD问卷。患者在能力(9.47对8.55)和成本(9.54对8.26)方面的评分高于医生,而在信息(9.31对9.43)和医疗连续性(8.40对9.01)方面的评分较低。经验不足(<12年)的医生在能力(8.0对9.01)、礼貌(8.12对10.0)和自主性(8.97对10.0)方面对QI评分的评价较差。医生认为成本领域不令人满意。

结论

意大利患者和医生对医疗保健的总体评价是令人满意的。医生低估了自己的能力,并认为医疗管理成本不令人满意。患者对医疗连续性和信息更为挑剔。特定国家的医疗质量数据使地方政府能够更有效地分配资源。

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