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亚的斯亚贝巴公立和私立医院以患者为中心的护理及相关因素:患者视角

Patient-Centered Care and Associated Factors at Public and Private Hospitals of Addis Ababa: Patients' Perspective.

作者信息

Birhanu Frehiwot, Yitbarek Kiddus, Addis Animut, Alemayehu Dereje, Shifera Nigusie

机构信息

Department of Health Service Management, School of Public Health, College of Health Science, Mizan-Tepi University, Mizan-Aman, Ethiopia.

Department of Health Policy and Management, Faculty of Public Health, Jimma University, Jimma, Ethiopia.

出版信息

Patient Relat Outcome Meas. 2021 May 20;12:107-116. doi: 10.2147/PROM.S301771. eCollection 2021.

Abstract

BACKGROUND

Patient-centered care is a practice of caring for patients in ways that are valuable to the individual patient and families. Implementation of the practice is a common problem worldwide. In Ethiopia, the available information is limited and is largely skewed to certain dimensions of the practice.

OBJECTIVE

To assess the patient-centered health care practice and associated factors among public and private general hospitals of Addis Ababa 2020.

METHODS

An institution-based comparative cross-sectional study was conducted in two public, and seven private general hospitals located in Addis Ababa from April 08 to May 20, 2020. A multistage sampling technique was employed to select the study participants. Data were collected using an interviewer-administered structured questioner, then entered into Epi-data version 3.1, and finally analyzed using SPSS version 25. Multivariable logistic regression was used to identify independent predictors of clients' perceived patient-centered care. Statistical significance was declared at p-value <0.05 and adjusted odds ratio with 95% confidence interval.

RESULTS

A total of 570 patients were involved with 99.8% response rate. About 49% (95% CI: 45.0-53.1) of patients rated the practice as good. It was 27.8% (95% CI: 22.5-33.1), and 70.2% (95% CI: 64.6-75.4) for public, and private hospitals, respectively Hospital type (AOR:0.21; 95% CI: 0.13-0.35), service easiness (AOR:3.3; 95% CI: 2.0-5.8), hospital attractiveness (AOR:2.3; 95% CI: 1.2,4.5), privacy to access care (AOR:2.0; 95% CI: 1.1,4.1), information on plan of care (AOR:2.3; 95% CI; 1.1,4.6), information on medication (AOR:3.1; 95% CI; 1.5,6.3), and perceived intimacy with the provider (AOR: 0.4; 95% CI;0.2,0.8) were the factors associated with the practice.

CONCLUSION

Even though providing patient-centered care has been the focus of quality improvement in Ethiopia, this study showed it is mostly being implemented from the traditional provider-centered approach and public hospitals were lower in practice than private hospitals.

摘要

背景

以患者为中心的护理是一种以对个体患者及其家庭有价值的方式来照顾患者的实践。这种实践的实施是一个全球性的普遍问题。在埃塞俄比亚,现有的信息有限,并且在很大程度上偏向于该实践的某些方面。

目的

评估2020年亚的斯亚贝巴公立和私立综合医院以患者为中心的医疗保健实践及相关因素。

方法

2020年4月8日至5月20日,在亚的斯亚贝巴的两家公立医院和七家私立综合医院进行了一项基于机构的比较横断面研究。采用多阶段抽样技术选择研究参与者。使用由访谈员管理的结构化问卷收集数据,然后输入Epi - data 3.1版本,最后使用SPSS 25版本进行分析。多变量逻辑回归用于确定患者感知的以患者为中心的护理的独立预测因素。当p值<0.05且调整后的优势比具有95%置信区间时,声明具有统计学意义。

结果

共有570名患者参与,回复率为99.8%。约49%(95%置信区间:45.0 - 53.1)的患者将该实践评为良好。公立医院为27.8%(95%置信区间:22.5 - 33.1),私立医院为70.2%(95%置信区间:64.6 - 75.4)。医院类型(调整后的优势比:0.21;95%置信区间:0.13 - 0.35)、服务便捷性(调整后的优势比:3.3;95%置信区间:2.0 - 5.8)、医院吸引力(调整后的优势比:2.3;95%置信区间:1.2,4.5)、获得护理的隐私性(调整后的优势比:2.0;95%置信区间:1.1,4.1)、护理计划信息(调整后的优势比:2.3;95%置信区间;1.1,4.6)、药物信息(调整后的优势比:3.1;95%置信区间;1.5,6.3)以及与提供者的亲密感(调整后的优势比:0.4;95%置信区间;0.2,0.8)是与该实践相关的因素。

结论

尽管提供以患者为中心的护理一直是埃塞俄比亚质量改进的重点,但本研究表明,它大多是从传统的以提供者为中心的方法实施的,并且公立医院在实践中的表现低于私立医院。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e8c6/8144361/80e2d049ff33/PROM-12-107-g0001.jpg

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