RAND Corporation, Santa Monica, CA.
Centers for Medicare & Medicaid Services, Baltimore, MD.
Med Care. 2019 Jan;57(1):42-48. doi: 10.1097/MLR.0000000000001005.
The emergency department (ED) setting is unique and measuring quality of care in the ED requires the development of ED-specific tools. The Emergency Department Patient Experience of Care Discharged to Community Survey was designed to measure patient experience in the ED setting.
Describe results from the Emergency Department Patient Experience of Care Discharged to Community Survey including respondent characteristics and reported patient experience, and examine factors, including mode of survey administration, associated with response propensity and response patterns.
In total, 16,006 discharges were sampled from 50 hospitals nationwide to receive the survey using a mode experiment design. Logistic regression modeled response propensity; linear regression examined associations between response patterns and patient characteristics and mode.
In total, 3122 survey respondents.
Measures of patient experience.
Patients reported that hospitals consistently informed them of the purpose of any new medications (84% yes, definitely), but did not consistently explain their possible side effects (53%). Age, education, health, and arrival by ambulance were significantly associated with response patterns. There were significant differences in response rate by mode: 29% mixed mode, 22% telephone only and 14% mail only. Mode of administration was significantly associated with response patterns whereby patients surveyed using telephone-only or mixed mode tended to respond more positively than those surveyed using mail only.
There is room for improvement in terms of patient experience in the ED setting. Effects of patient characteristics and survey mode on responses were large enough to necessitate appropriate adjustments if hospitals are to be compared in the future.
急诊部（ED）的环境独特，需要开发特定于 ED 的工具来衡量护理质量。《急诊患者社区出院体验护理调查》旨在测量 ED 环境中的患者体验。
描述《急诊患者社区出院体验护理调查》的结果，包括受访者特征和报告的患者体验，并研究与响应倾向和响应模式相关的因素，包括调查管理模式。
在全国范围内，从 50 家医院中抽取了 16006 例出院患者进行抽样调查，采用模式实验设计进行调查。逻辑回归模型用于预测响应倾向；线性回归检验了响应模式与患者特征和模式之间的关联。
共有 3122 名调查对象。
患者体验的测量指标。
患者表示，医院始终告知他们新药物的用途（84%的人表示“肯定”），但并未始终解释其可能的副作用（53%）。年龄、教育程度、健康状况和救护车到达与响应模式显著相关。不同模式的响应率存在显著差异：混合模式为 29%，仅电话为 22%，仅邮件为 14%。管理模式与响应模式显著相关，通过电话或混合模式进行调查的患者比仅通过邮件进行调查的患者更倾向于做出积极响应。
ED 环境中的患者体验仍有改进空间。患者特征和调查模式对响应的影响很大，如果未来要对医院进行比较，就需要进行适当的调整。
