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收集患者报告的结局指标对风湿病诊所就诊满意度的影响。

The influence of collecting patient-reported outcome measures on visit satisfaction in rheumatology clinics.

作者信息

Honomichl Ryan, Katzan Irene, Thompson Nicolas, Abelson Abby, Deal Chad, Rose Susannah, Lapin Brittany

机构信息

Department of Quantitative Health Sciences.

Neurological Institute Center for Outcomes Research & Evaluation.

出版信息

Rheumatol Adv Pract. 2020 Sep 1;4(2):rkaa046. doi: 10.1093/rap/rkaa046. eCollection 2020.

Abstract

OBJECTIVES

Patient-reported outcome measures (PROMs) can direct patient-centred care and increase patient satisfaction with the visit. The objective of this study was to assess the relationship between the collection of PROMs and visit satisfaction, as measured by the Clinician and Group Practice Consumer Assessment of Healthcare Providers and Systems (CG-CAHPS) survey.

METHODS

An electronic platform for collection of patient-reported information was implemented in rheumatology clinics between August and September 2016. Adult patients were included in the study if they completed CG-CAHPS after an ambulatory visit. The pre-implementation cohort consisted of patients seen between January and June 2016; the post-implementation cohort consisted of patients seen between January and June 2017. The CG-CAHPS scores were compared between cohorts. Mixed effect models were constructed to identify predictors of visit satisfaction.

RESULTS

Characteristics were similar between the 2117 pre- and 2380 post-implementation patients. Visit satisfaction was high in both cohorts but did not differ [odds ratio = 0.97 (95% CI: 0.79, 1.19)]. Predictors of improved satisfaction included being an established patient, being male, older age and reporting higher quality of life. However, sensitivity analyses in the post-implementation cohort suggested that implementing PROMs might convey benefits for new patients, in particular.

CONCLUSION

Collection of PROMs had no effect on visit satisfaction in rheumatology clinics, although there might be benefits for new patients. These largely null findings might be attributable to high satisfaction levels in our cohorts or to lack of provider review of PROM data with patients. Further research is indicated to determine the impact of provider communication of PROM results to patients on different domains of visit satisfaction.

摘要

目的

患者报告结局测量(PROMs)可指导以患者为中心的医疗服务,并提高患者对就诊的满意度。本研究的目的是评估PROMs收集情况与就诊满意度之间的关系,就诊满意度通过医疗服务提供者与系统临床医生及团体执业者消费者评估(CG-CAHPS)调查进行衡量。

方法

2016年8月至9月期间,在风湿病诊所实施了一个用于收集患者报告信息的电子平台。如果成年患者在门诊就诊后完成了CG-CAHPS调查,则纳入本研究。实施前队列包括2016年1月至6月就诊的患者;实施后队列包括2017年1月至6月就诊的患者。比较两个队列的CG-CAHPS评分。构建混合效应模型以确定就诊满意度的预测因素。

结果

2117名实施前患者和2380名实施后患者的特征相似。两个队列的就诊满意度均较高,但无差异[优势比 = 0.97(95%置信区间:0.79,1.19)]。满意度提高的预测因素包括为老患者、男性、年龄较大以及报告生活质量较高。然而,实施后队列的敏感性分析表明,实施PROMs可能尤其对新患者有益。

结论

在风湿病诊所,收集PROMs对就诊满意度没有影响,尽管可能对新患者有益。这些基本上为零的结果可能归因于我们队列中的高满意度水平,或者是由于医疗服务提供者未与患者一起审查PROM数据。需要进一步研究以确定医疗服务提供者向患者传达PROM结果对就诊满意度不同领域的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad1a/7607157/04453147eb59/rkaa046f1.jpg

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