Belasen Ariel, Belasen Alan T
Department of Economics and Finance, Southern Illinois University Edwardsville , Edwardsville, Illinois, USA.
MBA Program, SUNY Empire State College, Saratoga Springs, New York, USA.
J Health Organ Manag. 2018 Oct 8;32(7):891-907. doi: 10.1108/JHOM-10-2017-0262. Epub 2018 Oct 26.
The purpose of this paper is to explore the extent to which improving doctor-patient communication (DPC) can address and alleviate many healthcare delivery inefficiencies.
DESIGN/METHODOLOGY/APPROACH: The authors survey causes and costs of miscommunication including perceptual gaps between how physicians believe they perform their communicative duties vs how patients feel and highlight thresholds such as the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) used by hospitals to identify health outcomes and improve DPC.
The authors find that DPC correlates with better and more accurate care as well as with more satisfied patients. The authors utilize an assessment framework, doctor-patient communication assessment (DPCA), empirically measuring the effectiveness of DPC. While patient care is sometimes viewed as purely technical, there is evidence that DPC strongly predicts clinical outcomes as well as patients' overall ratings of hospitals.
RESEARCH LIMITATIONS/IMPLICATIONS: More research is needed to extend our understanding of the impact of the DPC on the overall HCAHPS ratings of hospitals. The authors think that researchers should adopt a qualitative method (e.g. content analysis) for analyzing DPC discourse.
When a sufficient amount of DPCA training is initiated, a norming procedure could be developed and a database may be employed to demonstrate training program's efficacy, a critical factor in establishing the credibility of the measurement program and nurturing support for its use.
ORIGINALITY/VALUE: The authors highlight clinical and operational issues as well as costs associated with miscommunication and the need to use metrics such as HCAHPS that allow consumers to see how hospitals differ on specific characteristics.
本文旨在探讨改善医患沟通（DPC）在多大程度上能够解决并缓解许多医疗服务效率低下的问题。
设计/方法/途径：作者调查了沟通不畅的原因和成本，包括医生认为自己履行沟通职责的方式与患者感受之间的认知差距，并强调了诸如医院用于识别健康结果和改善医患沟通的医院消费者医疗服务评价（HCAHPS）等阈值。
作者发现，医患沟通与更好、更准确的护理以及更满意的患者相关。作者采用了一个评估框架，即医患沟通评估（DPCA），以实证方式衡量医患沟通的有效性。虽然患者护理有时被视为纯粹的技术问题，但有证据表明，医患沟通能有力地预测临床结果以及患者对医院的总体评价。
研究局限性/启示：需要更多研究来扩展我们对医患沟通对医院总体HCAHPS评分影响的理解。作者认为，研究人员应采用定性方法（如内容分析）来分析医患沟通话语。
当启动足够数量的DPCA培训时，可以制定一个标准化程序，并利用数据库来证明培训项目的效果，这是建立测量项目可信度并培养对其使用支持的关键因素。
原创性/价值：作者强调了临床和运营问题以及与沟通不畅相关的成本，以及使用诸如HCAHPS等指标的必要性，这些指标能让消费者了解医院在特定特征方面的差异。
