Farmer Jane, Bigby Christine, Davis Hilary, Carlisle Karen, Kenny Amanda, Huysmans Richard
Social Innovation Research Institute, Swinburne University of Technology, John Street, Hawthorn, Melbourne, Australia.
Living with Disability Research Centre, La Trobe University, Bundoora, Melbourne, Australia.
BMC Health Serv Res. 2018 Aug 10;18(1):628. doi: 10.1186/s12913-018-3433-y.
Involving consumers in producing health services is mandated in many countries. Evidence indicates consumer partnerships lead to improved service design, quality and innovation. Involving participants from minority groups is crucial because poor understanding of distinctive needs affects individuals' service experiences and outcomes. Few studies consider service compliance with consumer partnering requirements or inclusion of minority group participants.
An online survey structured by domains of the Australian National Safety and Quality in Health Service Standards (NSQHS, 2013), was conducted. Questions covered consumer partnering in service planning, management and evaluation plus patient care design and inclusion of consumers from minority groups. Approximately 1200 Australian hospital and day surgery services were identified and 447 individual email addresses were identified for staff leading consumer partnerships. Quantitative data were analysed using SPSS. Qualitative responses, managed in NVivo, were analysed thematically. Frequencies were produced to indicate common activities and range of activities within question domains.
Comprehensive responses were received from 115 services (25.7%), including metropolitan and non-metropolitan, private and public service settings. Most respondents (95.6%) "partnered with consumers to develop or provide feedback on patient information". Regarding inclusion of participants from minority groups, respondents were least likely to specifically include those from socially disadvantaged backgrounds (23.6%). Public health services were more likely than private services to engage with consumers.
The survey is the first to include responses about consumer partnering from across Australia. While many respondents partner with consumers, it is clear that more easily-organised activity such as involvement in existing committees or commenting on patient information occurs more commonly than involvement in strategy or governance. This raises questions over whether strategic-level involvement is too difficult or unrealistic; or whether services simply lack tools. Minority views may be missed where there is a lack of specific action to include diversity. Future work might address why services choose the activities we found and probe emerging opportunities, such as using social media or online engagement.
许多国家都要求让消费者参与健康服务的提供。有证据表明，消费者伙伴关系能带来更好的服务设计、质量和创新。让少数群体的参与者参与进来至关重要，因为对独特需求的理解不足会影响个人的服务体验和结果。很少有研究考虑服务是否符合消费者伙伴关系要求或是否纳入了少数群体参与者。
开展了一项在线调查，该调查由澳大利亚国家卫生服务安全与质量标准（NSQHS，2013）的各个领域构建。问题涵盖了消费者在服务规划、管理和评估中的伙伴关系，以及患者护理设计和少数群体消费者的纳入情况。确定了约1200家澳大利亚医院和日间手术服务机构，并为领导消费者伙伴关系的工作人员确定了447个个人电子邮件地址。使用SPSS对定量数据进行分析。在NVivo中管理的定性回复进行了主题分析。生成了频率数据以表明问题领域内的常见活动和活动范围。
收到了115项服务（25.7%）的全面回复，包括大都市和非大都市、私立和公立服务机构。大多数受访者（95.6%）“与消费者合作开发或提供有关患者信息的反馈”。关于纳入少数群体的参与者，受访者最不可能专门纳入社会弱势背景的人（23.6%）。公共卫生服务机构比私立服务机构更有可能与消费者互动。
该调查是首次涵盖澳大利亚各地关于消费者伙伴关系回复的调查。虽然许多受访者与消费者建立了伙伴关系，但很明显，参与现有委员会或对患者信息发表评论等更容易组织的活动比参与战略或治理更为常见。这就引发了一个问题，即战略层面的参与是否太难或不现实；或者服务机构是否只是缺乏工具。如果缺乏纳入多样性的具体行动，可能会遗漏少数群体的观点。未来的工作可能会探讨服务机构选择我们所发现的活动的原因，并探索新出现的机会，比如使用社交媒体或在线参与。
