Honeyford Kate, Greaves Felix, Aylin Paul, Bottle Alex
Dr Foster Unit at Imperial College, London, England.
Department of Primary Care and Public Health, Imperial College, London, England.
PLoS One. 2017 Oct 26;12(10):e0187012. doi: 10.1371/journal.pone.0187012. eCollection 2017.
To examine trends in patient experience and consistency between hospital trusts and settings.
Observational study of publicly available patient experience surveys of three hospital settings (inpatients (IP), accident and emergency (A&E) and outpatients (OP)) of 130 acute NHS hospital trusts in England between 2004/05 and 2014/15.
Overall patient experience has been good, showing modest improvements over time across the three hospital settings. Individual questions with the biggest improvement across all three settings are cleanliness (IP: +7.1, A&E: +6.5, OP: +4.7) and information about danger signals (IP: +3.8, A&E: +3.9, OP: +4.0). Trust performance has been consistent over time: 71.5% of trusts ranked in the same cluster for more than five years. There is some consistency across settings, especially between outpatients and inpatients. The lowest-scoring questions, regarding information at discharge, are the same in all years and all settings.
The greatest improvement across all three settings has been for cleanliness, which has seen national policies and targets. Information about danger signals and medication side-effects showed least consistency across settings and scores have remained low over time, despite information about danger signals showing a big increase in score. Patient experience of aspects of access and waiting have declined, as has experience of discharge delay, likely reflecting known increases in pressure on England's NHS.
研究患者体验的趋势以及医院信托机构与不同科室之间的一致性。
对2004/05年至2014/15年间英格兰130家国民保健服务(NHS)急性医院信托机构的三种医院科室(住院患者(IP)、急诊(A&E)和门诊患者(OP))的公开患者体验调查进行观察性研究。
总体患者体验良好,随着时间推移,这三种医院科室的体验均有适度改善。在所有三种科室中改善最大的单项问题是清洁度(住院患者:+7.1,急诊:+6.5,门诊患者:+4.7)以及危险信号信息(住院患者:+3.8,急诊:+3.9,门诊患者:+4.0)。信托机构的表现长期保持一致:71.5%的信托机构在五年多的时间里都处于同一类别。不同科室之间存在一定的一致性,尤其是门诊患者和住院患者之间。关于出院信息的得分最低的问题在所有年份和所有科室都是相同的。
所有三种科室中改善最大的是清洁度,这方面有国家政策和目标。危险信号和药物副作用信息在不同科室之间的一致性最差,尽管危险信号信息的得分大幅提高,但随着时间推移得分仍然较低。患者在就医和等待方面的体验有所下降,出院延迟的体验也是如此,这可能反映了英格兰国民保健服务面临的压力增加这一已知情况。