Mirzoev Tolib, Kane Sumit
a Nuffield Centre for International Health and Development , University of Leeds , Leeds , UK.
b Nossal Institute for Global Health, Melbourne School of Population and Global Health , University of Melbourne , Melbourne , Australia.
Glob Health Action. 2018;11(1):1458938. doi: 10.1080/16549716.2018.1458938.
Information from patient complaints - a widely accepted measure of patient satisfaction with services - can inform improvements in service quality, and contribute towards overall health systems performance. While analyses of data from patient complaints received much emphasis, there is limited published literature on key interventions to improve complaint management systems.
The objectives are two-fold: first, to synthesise existing evidence and provide practical options to inform future policy and practice and, second, to identify key outstanding gaps in the existing literature to inform agenda for future research.
We report results of review of the existing literature. Peer-reviewed published literature was searched in OVID Medline, OVID Global Health and PubMed. In addition, relevant citations from the reviewed articles were followed up, and we also report grey literature from the UK and the Netherlands.
Effective interventions can improve collection of complaints (e.g. establishing easy-to-use channels and raising patients' awareness of these), analysis of complaint data (e.g. creating structures and spaces for analysis and learning from complaints data), and subsequent action (e.g. timely feedback to complainants and integrating learning from complaints into service quality improvement). No one single measure can be sufficient, and any intervention to improve patient complaint management system must include different components, which need to be feasible, effective, scalable, and sustainable within local context.
Effective interventions to strengthen patient complaints systems need to be: comprehensive, integrated within existing systems, context-specific and cognizant of the information asymmetry and the unequal power relations between the key actors. Four gaps in the published literature represent an agenda for future research: limited understanding of contexts of effective interventions, absence of system-wide approaches, lack of evidence from low- and middle-income countries and absence of focused empirical assessments of behaviour of staff who manage patient complaints.
患者投诉信息——一种被广泛认可的患者对服务满意度的衡量标准——可为服务质量的改进提供信息，并有助于提升整体卫生系统绩效。虽然对患者投诉数据的分析备受关注，但关于改善投诉管理系统的关键干预措施的已发表文献有限。
目标有两个：第一，综合现有证据并提供实用选项，为未来政策和实践提供参考；第二，识别现有文献中关键的突出差距，为未来研究议程提供参考。
我们报告对现有文献的综述结果。在OVID Medline、OVID Global Health和PubMed中检索经过同行评审的已发表文献。此外，对综述文章中的相关引用进行了追踪，我们还报告了来自英国和荷兰的灰色文献。
有效的干预措施可以改善投诉收集（例如建立易于使用的渠道并提高患者对这些渠道的认识）、投诉数据分析（例如创建分析结构和空间并从投诉数据中学习）以及后续行动（例如及时向投诉者反馈并将从投诉中获得的经验教训纳入服务质量改进）。没有一项单一措施是足够的，任何改善患者投诉管理系统的干预措施都必须包括不同的组成部分，这些组成部分需要在当地背景下可行、有效、可扩展且可持续。
加强患者投诉系统的有效干预措施需要：全面、融入现有系统、因地制宜，并认识到关键行为者之间的信息不对称和不平等权力关系。已发表文献中的四个差距代表了未来研究议程：对有效干预措施背景的理解有限、缺乏全系统方法、缺乏来自低收入和中等收入国家的证据以及缺乏对管理患者投诉的工作人员行为的重点实证评估。
