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心力衰竭患者护理的卫生系统响应性:来自一家大学医院的证据。

Health system responsiveness for care of patients with heart failure: evidence from a university hospital.

作者信息

Karami-Tanha Farzaneh, Moradi-Lakeh Maziar, Fallah-Abadi Hamidreza, Nojomi Marzieh

机构信息

Department of Community Medicine, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Shahid-Rajaei hospital. School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

出版信息

Arch Iran Med. 2014 Nov;17(11):736-40.

Abstract

BACKGROUND

Responsiveness refers to non-clinical aspects of the health system and responds to this question that whether health system is responsive to rightful expectations of people. The present study was conducted to determine the health system responsiveness about chronic heart failure patients in one of the main heart centers in Tehran during 2012 - 2013.

METHODS

In this cross-sectional study 300 patients have completed a valid questionnaire that designed by World Health Organization (WHO) for measurement of responsiveness. Analysis of data was based on analysis WHO multi-country study that was designed to evaluate responsiveness in health care systems.

RESULTS

In outpatient services, worst performance was related to choice and prompt attention domains (35.8% and 35.1%). Autonomy (31.5%) has the worst performance of inpatient services. Both in outpatient and inpatient services "confidentiality of information" has the best performance (87.8% and 85.6%). Responsiveness of the health system in inpatient services has the worst performance comparing to outpatient services (57.2% versus 66.5%). Most important domains from patient's view were prompt attention and dignity (47% and 23%).

CONCLUSION

More attention to patient's rights, giving them opportunity to choose health care services (choice), providing fast access to emergency care (prompt attention) and considering autonomy are most important aspects of health responsiveness.  From patient's view "prompt attention" was reported as the most important aspect of responsiveness.

摘要

背景

响应性是指卫生系统的非临床方面,回答的问题是卫生系统是否对人们的合理期望做出响应。本研究旨在确定2012 - 2013年期间德黑兰一个主要心脏中心对慢性心力衰竭患者的卫生系统响应性。

方法

在这项横断面研究中,300名患者完成了一份由世界卫生组织(WHO)设计的用于测量响应性的有效问卷。数据分析基于WHO多国研究的分析,该研究旨在评估卫生保健系统的响应性。

结果

在门诊服务中,最差表现与选择和及时关注领域相关(分别为35.8%和35.1%)。自主性(31.5%)在住院服务中表现最差。在门诊和住院服务中,“信息保密性”表现最佳(分别为87.8%和85.6%)。与门诊服务相比,住院服务中卫生系统的响应性表现最差(57.2%对66.5%)。从患者角度来看,最重要的领域是及时关注和尊严(分别为47%和23%)。

结论

更多关注患者权利,给予他们选择医疗服务的机会(选择),提供快速获得紧急护理的途径(及时关注)以及考虑自主性是卫生响应性的最重要方面。从患者角度来看,“及时关注”被报告为响应性的最重要方面。

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