Atinga Roger A, Bawole Justice N, Nang-Beifubah Alexis
Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Accra, Ghana.
Department of Public Administration and Health Services Management, University of Ghana Business School, Legon, Accra, Ghana.
Patient Educ Couns. 2016 Mar;99(3):370-377. doi: 10.1016/j.pec.2015.09.008. Epub 2015 Oct 9.
To examine differences in patient-centred care among private and public inpatients in public hospitals and whether satisfaction with patient-centred care differ between the patient groups.
Cross-sectional data collected from inpatients in private wards (n=300) and public wards (n=520) in Ghana, using a structured questionnaire modelled on four dimensions of patient-centred care: respect and dignity, emotional support, interpersonal relations and information sharing.
Patient-centred care differed significantly among private and public patients (p<0.001), with an effect size ranging from medium to large. Private patients rated patient-centred care higher than public patients in all the items of the four dimensions. Satisfaction with patient-centred care discriminated between the patient groups. Satisfaction was significantly high for private patients who are aged 50+ (p<0.001), had high education (p<0.05) and high income (p<0.001) compared to the same category of public patients.
Physicians behaviour is stereotyping and less favourable to public patients, suggesting inequitable access to patient-centred care for inpatients from high and low socioeconomic backgrounds.
Hospitals with private and public wards should be compelled to properly coordinate and regulate the activities of physicians to avoid fragmented care for inpatients.
研究公立医院中私立病房和公立病房患者在以患者为中心的护理方面的差异，以及不同患者群体对以患者为中心的护理的满意度是否存在差异。
采用基于以患者为中心的护理的四个维度（尊重与尊严、情感支持、人际关系和信息共享）构建的结构化问卷，收集加纳私立病房（n = 300）和公立病房（n = 520）住院患者的横断面数据。
私立和公立患者在以患者为中心的护理方面存在显著差异（p < 0.001），效应大小从中等到较大。在四个维度的所有项目中，私立患者对以患者为中心的护理的评分均高于公立患者。不同患者群体对以患者为中心的护理的满意度存在差异。与同类别公立患者相比，年龄在50岁及以上（p < 0.001）、受过高等教育（p < 0.05）和高收入（p < 0.001）的私立患者满意度显著较高。
医生的行为存在刻板印象，对公立患者不太有利，这表明社会经济背景高低不同的住院患者在获得以患者为中心的护理方面存在不公平现象。
设有私立和公立病房的医院应被迫妥善协调和规范医生的活动，以避免对住院患者的护理出现碎片化情况。
