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医患沟通和医院评级:感知差距及对 COVID-19 影响的前瞻性思考。

Provider-patient communication and hospital ratings: perceived gaps and forward thinking about the effects of COVID-19.

机构信息

MBA in Healthcare Leadership SUNY Empire State College, 113 West Avenue, Saratoga Springs, NY 12866, USA.

David d. Reh School of Business, 80 Nott Terrace, Schenectady, NY 12308, USA 33174, USA.

出版信息

Int J Qual Health Care. 2021 Feb 20;33(1). doi: 10.1093/intqhc/mzaa140.

Abstract

OBJECTIVES

To highlight clinical and operational issues, identify factors that shape patient responses in Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and test the correlations between composite measures and overall hospital ratings.

DESIGN

Responses to HCAHPS surveys were used in a partial correlation analysis to ascertain those HCAHPS composite measures that most relate to overall hospital ratings. The linear mean scores for the composite measures and individual and global items were analyzed with descriptive analysis and correlation analysis via JMP and SPSS statistical software.

SETTING

HCAHPS is a patient satisfaction survey required by the Centers for Medicare and Medicaid Services for hospitals in the USA. The survey is for adult inpatients, excluding psychiatric patients.

PARTICIPANTS

3382 US hospitals.

INTERVENTION

None.

MAIN OUTCOME MEASURE

Pearson correlation coefficients for the six composite measures and overall hospital rating.

RESULTS

The partial correlations for overall hospital rating and three composite measures are positive and moderately strong for care transition (0.445) and nurse communication (0.369) and weak for doctor communication (0.066).

CONCLUSIONS

From a health policy standpoint, it is imperative that hospital administrators stress open and clear communication between providers and patients to avoid problems ranging from misdiagnosis to incorrect treatment. Additional research is needed to determine how the coronavirus of 2019 pandemic influences patients' perceptions of quality and willingness to recommend hospitals at a time when nurses and physicians show symptoms of burnout due to heavy workloads and inadequate personal protective equipment.

摘要

目的

强调临床和运营问题,确定影响医院患者评估医疗保健提供者和系统(HCAHPS)患者反应的因素,并检验综合措施与整体医院评分之间的相关性。

设计

使用 HCAHPS 调查的回复进行偏相关分析,以确定与整体医院评分最相关的 HCAHPS 综合措施。使用 JMP 和 SPSS 统计软件通过描述性分析和相关性分析,对综合措施和个体及整体项目的线性平均值进行分析。

设置

HCAHPS 是美国医疗保险和医疗补助服务中心要求的患者满意度调查,适用于除精神科患者外的美国成年住院患者。

参与者

3382 家美国医院。

干预措施

无。

主要观察指标

六个综合措施和整体医院评分的 Pearson 相关系数。

结果

整体医院评分与三个综合措施的偏相关系数均为正且中度强,对转院护理(0.445)和护士沟通(0.369),对医生沟通(0.066)则为弱相关。

结论

从卫生政策角度来看,医院管理人员必须强调提供者与患者之间的开放和明确沟通,以避免从误诊到错误治疗等问题。需要进一步研究,以确定 2019 年冠状病毒大流行如何影响患者对质量的感知以及在护士和医生因工作量大且个人防护设备不足而出现倦怠症状时推荐医院的意愿。

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