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法国改善精神卫生保健质量的患者报告体验测量(PREMIUM)项目:开发与实施策略的研究方案

The Patient-Reported Experience Measure for Improving qUality of care in Mental health (PREMIUM) project in France: study protocol for the development and implementation strategy.

作者信息

Fernandes Sara, Fond Guillaume, Zendjidjian Xavier, Michel Pierre, Baumstarck Karine, Lancon Christophe, Berna Fabrice, Schurhoff Franck, Aouizerate Bruno, Henry Chantal, Etain Bruno, Samalin Ludovic, Leboyer Marion, Llorca Pierre-Michel, Coldefy Magali, Auquier Pascal, Boyer Laurent

机构信息

Aix-Marseille University, School of Medicine, CEReSS - Health Service Research and Quality of Life Center - EA 3279 Research Unit, Marseille, France, Email

FondaMental Foundation, Créteil, France.

出版信息

Patient Prefer Adherence. 2019 Jan 21;13:165-177. doi: 10.2147/PPA.S172100. eCollection 2019.

Abstract

BACKGROUND

Measuring the quality and performance of health care is a major challenge in improving the efficiency of a health system. Patient experience is one important measure of the quality of health care, and the use of patient-reported experience measures (PREMs) is recommended. The aims of this project are 1) to develop item banks of PREMs that assess the quality of health care for adult patients with psychiatric disorders (schizophrenia, bipolar disorder, and depression) and to validate computerized adaptive testing (CAT) to support the routine use of PREMs; and 2) to analyze the implementation and acceptability of the CAT among patients, professionals, and health authorities.

METHODS

This multicenter and cross-sectional study is based on a mixed method approach, integrating qualitative and quantitative methodologies in two main phases: 1) item bank and CAT development based on a standardized procedure, including conceptual work and definition of the domain mapping, item selection, calibration of the item bank and CAT simulations to elaborate the administration algorithm, and CAT validation; and 2) a qualitative study exploring the implementation and acceptability of the CAT among patients, professionals, and health authorities.

DISCUSSION

The development of a set of PREMs on quality of care in mental health that overcomes the limitations of previous works (ie, allowing national comparisons regardless of the characteristics of patients and care and based on modern testing using item banks and CAT) could help health care professionals and health system policymakers to identify strategies to improve the quality and efficiency of mental health care.

TRIAL REGISTRATION

NCT02491866.

摘要

背景

衡量医疗保健的质量和绩效是提高卫生系统效率的一项重大挑战。患者体验是医疗保健质量的一项重要指标,建议使用患者报告体验指标(PREMs)。本项目的目标是:1)开发用于评估患有精神疾病(精神分裂症、双相情感障碍和抑郁症)的成年患者医疗保健质量的PREMs题库,并验证计算机自适应测试(CAT)以支持PREMs的常规使用;2)分析CAT在患者、专业人员和卫生当局中的实施情况和可接受性。

方法

本多中心横断面研究基于混合方法,在两个主要阶段整合定性和定量方法:1)基于标准化程序开发题库和CAT,包括概念工作和领域映射定义、项目选择、题库校准和CAT模拟以制定施测算法以及CAT验证;2)一项定性研究,探索CAT在患者、专业人员和卫生当局中的实施情况和可接受性。

讨论

开发一套关于精神卫生保健质量的PREMs,克服以往研究的局限性(即无论患者和护理的特征如何,都能进行全国性比较,并基于使用题库和CAT的现代测试),有助于医疗保健专业人员和卫生系统政策制定者确定提高精神卫生保健质量和效率的策略。

试验注册

NCT02491866。

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