The Centre for Psychiatry, Imperial College London, Hammersmith Campus, Commonwealth Building 7th Floor, Du Cane Road, London, W12 0NN, UK.
The Royal College of Psychiatrists' College Centre for Quality Improvement, London, E1 8BB, UK.
BMC Psychiatry. 2019 Jan 9;19(1):17. doi: 10.1186/s12888-018-1998-y.
Evidence is mounting that patient-reported experience can provide a valuable indicator of the quality of healthcare services. However, little is known about the relationship between the experiences of people with severe mental illness and the quality of care they receive. We conducted a study to examine the relationship between patient-reported experience and the quality of care provided to people with schizophrenia.
We calculated a composite global rating of quality of care for people with schizophrenia using data from an audit of 64 mental health providers. We then examined associations between these ratings and mean patient satisfaction and patient-rated outcome using data from a survey of 5608 schizophrenic patients treated in these services.
Global rating of quality of care was positively correlated with patient-rated outcome (r = 0.33; p = 0.01) but not with patient satisfaction (r = 0.21, p = 0.10). Patient-rated outcome was also positively correlated with patient involvement (r = 0.26, p = 0.04) and the quality of prescribing practice (r = 0.31, p = 0.02). High patient satisfaction scores were significantly associated with the extent of use of care plans within each organisation (r = 0.27, p = 0.03).
Among people with schizophrenia, patient-rated outcome provides a better guide to the quality of care than patient-rated satisfaction. Greater use of patient-reported outcome measures should be made when assessing the quality of care provided to people with psychosis.
越来越多的证据表明，患者报告的体验可以为医疗保健服务质量提供有价值的指标。然而，对于严重精神疾病患者的体验与他们所接受的护理质量之间的关系知之甚少。我们进行了一项研究，以检验患者报告的体验与为精神分裂症患者提供的护理质量之间的关系。
我们使用 64 家精神卫生服务提供者审核的数据计算了精神分裂症患者护理质量的综合全球评分。然后，我们使用这些服务中 5608 名精神分裂症患者的调查数据，研究了这些评分与平均患者满意度和患者评定结果之间的关联。
护理质量的全球综合评分与患者评定结果呈正相关（r=0.33；p=0.01），但与患者满意度无关（r=0.21，p=0.10）。患者评定结果也与患者参与度呈正相关（r=0.26，p=0.04）和处方实践质量呈正相关（r=0.31，p=0.02）。高患者满意度评分与每个组织内使用护理计划的程度显著相关（r=0.27，p=0.03）。
在精神分裂症患者中，患者评定结果比患者评定满意度更能指导护理质量。在评估为精神病患者提供的护理质量时，应更多地使用患者报告的结果测量指标。
