RAND Corporation, Santa Monica, California.
RAND Corporation, Pittsburgh, Pennsylvania.
J Healthc Manag. 2021;66(3):200-224. doi: 10.1097/JHM-D-20-00207.
Hospitals, physician groups, and other healthcare providers are investing in improved patient care experiences. Prior reviews have concluded that better patient care experiences are associated with less healthcare utilization and better adherence to recommended prevention and treatment, clinical outcomes, and patient safety within hospitals. No comprehensive review has examined the business case for investing in patient experiences. This article reviews the literature on associations between patient experience-measured from the perspective of patients and families-and business outcomes, including patient allegiance and retention, complaints, lawsuits, provider job satisfaction, and profitability. We searched U.S. English-language peer-reviewed articles from January 1990 to July 2019. We followed the preferred reporting items for systematic reviews and meta-analyses guidelines and undertook a full-text review of 564 articles, yielding the inclusion of 40 articles. Our review found that patients with positive care experiences are more likely to return to the same hospital and ambulatory settings for future healthcare needs, retain their health plan, and voice fewer complaints. Associations between patient experiences and profitability or provider job satisfaction were limited/mixed. This suggests that providers can pursue better patient care experiences for the intrinsic value to patients, while also recognizing it is good for intermediate business outcomes: specifically increased recommendations, better patient retention, and fewer complaints. Nursing and physician care, broadly defined, are the only specific aspects of patient experience consistently associated with retention, with evidence pointing to communication and trust as parts of care linked to the intent to return. These aspects of patient experience are also the largest contributors to the overall ratings of a provider or facility.
医院、医师团体和其他医疗保健提供者正在投资改善患者的护理体验。先前的综述得出结论,更好的患者护理体验与更少的医疗保健利用以及更好地遵守预防和治疗建议、临床结果以及医院内的患者安全有关。没有全面的综述审查过投资患者体验的商业案例。本文综述了从患者和家属的角度衡量的患者体验与商业结果之间的关联的文献,包括患者忠诚度和保留率、投诉、诉讼、提供者工作满意度和盈利能力。我们搜索了 1990 年 1 月至 2019 年 7 月的美国英语同行评审文章。我们遵循系统评价和荟萃分析报告的首选项目指南,并对 564 篇文章进行了全文审查,纳入了 40 篇文章。我们的综述发现,体验到积极护理的患者更有可能回到同一家医院和门诊环境来满足未来的医疗需求,保留他们的健康计划,并减少投诉。患者体验与盈利能力或提供者工作满意度之间的关联有限/混杂。这表明,提供者可以为患者的内在价值追求更好的患者护理体验,同时也认识到这对中间的业务结果有好处:特别是增加推荐、更好的患者保留和减少投诉。护理和医师护理,广义上的定义,是与保留率始终相关的患者体验的唯一特定方面,有证据表明沟通和信任是与返回意愿相关的护理的一部分。这些方面的患者体验也是提供者或医疗机构总体评分的最大贡献者。