Aysola Jaya, Xu Chang, Huo Hairong, Werner Rachel M
Division of General Internal Medicine, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, PA, USA.
Leonard Davis Institute of Health Economics, University of Pennsylvania, PA, USA.
J Patient Exp. 2020 Dec;7(6):1678-1684. doi: 10.1177/2374373520924190. Epub 2020 May 26.
We lack knowledge on how patient-reported experience relates to both quality of care services and visit attendance in the primary care setting. Therefore, in a cross-sectional analysis of 8355 primary care patients from 22 primary care practices, we examined the associations between visit-triggered patient-reported experience measures and both (1) quality of care measures and (2) number of missed primary care appointment (no shows). Our independent variables included both overall patient experience and its subdomains. Our outcomes included the following measures: smoking cessation discussion, diabetes eye examination referral, mammography, colonoscopy screening, current smoking status (nonsmoker vs smoker), diabetes control Hemoglobin A1c (HbA [<8]), blood pressure control, cholesterol control Low Density Lipoprotein (LDL) among patients with diabetes (LDL < 100), and visit no shows 2 and 5 years after the index visit that triggered the completed patient-experience survey. We found that patient experience, while an important stand-alone metric of care quality, may not relate to clinical outcomes or process measures in the outpatient setting. However, patient-reported experiences with their primary care provider appear to influence their future visit attendance.
我们并不清楚患者报告的体验与初级保健机构的护理服务质量及就诊率之间存在怎样的关联。因此,在对来自22家初级保健机构的8355名初级保健患者进行的横断面分析中,我们研究了就诊引发的患者报告体验指标与以下两方面之间的关联:(1)护理质量指标;(2)初级保健预约失约(未就诊)次数。我们的自变量包括患者总体体验及其子领域。我们的结果包括以下指标:戒烟讨论、糖尿病眼部检查转诊、乳房X光检查、结肠镜筛查、当前吸烟状况(非吸烟者与吸烟者)、糖尿病控制糖化血红蛋白(HbA[<8])、血压控制、糖尿病患者的胆固醇控制低密度脂蛋白(LDL<100),以及引发患者体验调查完成的首次就诊后2年和5年的未就诊情况。我们发现,患者体验虽是护理质量的一项重要独立指标,但在门诊环境中可能与临床结果或过程指标并无关联。然而,患者报告的与初级保健提供者的体验似乎会影响他们未来的就诊率。