Miró Òscar, Escoda Rosa, Martín-Sánchez Francisco Javier, Herrero Pablo, Jacob Javier, Alquézar Aitor, Aguirre Alfons, Gil Víctor, Andueza Juan Antonio, Llorens Pere
Área de Urgencias, Hospital Clínic, Barcelona; Grupo de Investigación "Urgencias: Procesos y Patologías", IDIBAPS, Barcelona, España.
Servicio de Urgencias, Hospital Clínico San Carlos, Madrid, España.
Emergencias. 2015 Jun;27(3):161-168.
To determine perception of quality of care for acute heart failure (AHF) of patients discharged from the emergency department in comparison with the perception of admitted patients; to explore the variables associated with perception of quality.
Prospective, cross-sectional case-control study in 7 emergency departments. Consecutive patients diagnosed with AHF were recruited to answer a telephone survey assessing their view of quality of physician care, nurse care, overall treatment, and degree of resolution of their problem in the emergency department. Discharged patients were also asked to state their level of agreement with the decision to send them home from the emergency department. The answers of patients who were discharged home were compared with patients who were admitted to the ward. The results were analyzed according to whether or not adverse events occurred within 30 days.
A total of 1147 patients were enrolled and 1003 (87.4%) were interviewed; 253 of the patients (25.2%) were discharged home. We found no significant differences in any of the assessments (on physician or nurse care, overall treatment, or degree of resolution) between patients who were discharged home and those who were admitted. The mean (SD) overall satisfaction assessments (on a scale of 0 to 10) were 7.34 (1.38) and 7.38 (1.52), respectively, in the 2 groups (P=.66). Over 90% of those discharged home agreed with or strongly agreed with the decision. Evaluations were unrelated to whether or not adverse events occurred in the next 30 dyas.
Patients with AHF have high opinions of the different components of care received in the emergency department, and their evaluations are unrelated to whether they were admitted or discharged home. Those discharged home agree with the decision and their opinion remains firm regardless of whether adverse events occur later.
与住院患者相比,确定急诊科出院的急性心力衰竭(AHF)患者对医疗质量的看法;探讨与质量看法相关的变量。
在7个急诊科进行前瞻性横断面病例对照研究。连续招募被诊断为AHF的患者,通过电话调查评估他们对医生护理、护士护理、整体治疗以及急诊科问题解决程度的看法。出院患者还被要求说明他们对从急诊科送回家这一决定的同意程度。将出院回家的患者的回答与住院患者的回答进行比较。根据30天内是否发生不良事件对结果进行分析。
共纳入1147例患者,1003例(87.4%)接受了访谈;253例患者(25.2%)出院回家。我们发现出院回家的患者与住院患者在任何评估(医生或护士护理、整体治疗或解决程度)方面均无显著差异。两组的平均(标准差)总体满意度评估(0至10分)分别为7.34(1.38)和7.38(1.52)(P = 0.66)。超过90%出院回家的患者同意或强烈同意该决定。评估与接下来30天内是否发生不良事件无关。
AHF患者对在急诊科接受的不同护理环节评价较高,且他们的评价与是否住院或出院回家无关。出院回家的患者同意该决定,无论之后是否发生不良事件,他们的意见都很坚定。