Harrison Reema, Walton Merrilyn, Kelly Patrick, Manias Elizabeth, Jorm Christine, Smith-Merry Jennifer, Iedema Rick, Luxford Karen, Dyda Amalie
School of Public Health and Community Medicine, University of New South Wales, Australia.
School of Public Health, University of Sydney, New South Wales, Australia.
Int J Qual Health Care. 2018 Jun 1;30(5):358-365. doi: 10.1093/intqhc/mzy024.
Evidence of the patient experience of hospitalization is an essential component of health policy and service improvement but studies often lack a representative population sample or do not examine the influence of patient and hospital characteristics on experiences. We address these gaps by investigating the experiences of a large cohort of recently hospitalized patients aged 45 years and over in New South Wales (NSW), Australia who were identified using data linkage.
Cross-sectional survey.
Hospitals in NSW, Australia.
The Picker Patient Experience Survey (PPE-15) was administered to a random sample of 20 000 patients hospitalized between January and June 2014.
Multivariable negative binomial regression was used to investigate factors associated with a higher PPE-15 score.
There was a 40% response rate (7661 completed surveys received). Respondents often reported a positive experience of being treated with dignity and respect, yet almost 40% wanted to be more involved in decisions about their care. Some respondents identified other problematic aspects of care such as receiving conflicting information from different care providers (18%) and feeling that doctors spoke in front of them as if they were not there (14%). Having an unplanned admission or having an adverse event were both very strongly associated with a poorer patient experience (P < 0.001). No other factors were found to be associated.
Patient involvement in decision-making about care was highlighted as an important area for improvement. Further work is needed to address the challenges experienced by patients, carers and health professionals in achieving a genuine partnership model.
患者住院体验的证据是卫生政策和服务改进的重要组成部分,但研究往往缺乏具有代表性的人群样本,或者没有考察患者及医院特征对体验的影响。我们通过调查澳大利亚新南威尔士州(NSW)一大群年龄在45岁及以上的近期住院患者的体验来填补这些空白,这些患者是通过数据链接识别出来的。
横断面调查。
澳大利亚新南威尔士州的医院。
对2014年1月至6月期间住院的20000名患者的随机样本进行了Picker患者体验调查(PPE - 15)。
采用多变量负二项回归来研究与较高PPE - 15得分相关的因素。
回复率为40%(共收到7661份完成的调查问卷)。受访者经常报告在接受治疗时感受到尊严和尊重的积极体验,但近40%的人希望更多地参与到关于其护理的决策中。一些受访者指出了护理的其他问题方面,例如从不同护理提供者那里收到相互矛盾的信息(占18%),以及感觉医生在他们面前交谈时就像他们不在场一样(占14%)。非计划入院或发生不良事件均与较差的患者体验密切相关(P < 0.001)。未发现其他相关因素。
患者参与护理决策被突出为一个需要改进的重要领域。需要进一步开展工作,以应对患者、护理人员和卫生专业人员在实现真正的伙伴关系模式方面所面临的挑战。