de Cruppé Werner, Kummer Marie-Charlotte, Geraedts Max
Institut für Versorgungsforschung und Klinische Epidemiologie, Philipps-Universitat Marburg Fachbereich Medizin, Marburg, Germany.
Medizin, Philipps-Universität Marburg Fachbereich Medizin, Marburg, Germany.
Zentralbl Chir. 2023 Feb;148(1):24-32. doi: 10.1055/a-1555-3907. Epub 2021 Sep 29.
Free hospital choice is promoted in health policy through public quality reporting. Previous studies on hospital choice mostly survey patients for specific elective procedures. This study examines all full inpatient surgical patients and compares them to those in other specialties. Research questions are: How many patients make their own decisions about the hospital? How much time do they have before admission? Where do they obtain information and what are their important decision criteria?
This study evaluates cross-sectional primary data on hospital choice collected by questionnaire from 1925 consecutively hospitalised patients from 11 medical specialties and 3 levels of care, including 438 surgical patients from 6 general surgery departments.
Three quarters of surgical patients decide on the hospital themselves. Their own previous experience with the hospital is an important source of information and decision-making criterion for a good half of the patients, along with relatives and outpatient treatment providers as well as the hospital reputation.
Many surgical patients decide in favour of a hospital because of the trust they have built up through previous treatment in the hospital, which they experience as satisfactory. The professional quality of treatment is thus the greatest impact factor on patients, their relatives and outpatient treatment providers. It is important to actively and specifically address and clarify possible dissatisfaction on the part of the patient before discharge.
通过公开质量报告在卫生政策中推行医院自由选择。以往关于医院选择的研究大多针对特定择期手术的患者进行调查。本研究对所有住院手术患者进行了考察,并将他们与其他专科的患者进行比较。研究问题如下:有多少患者自行决定就诊医院?入院前他们有多少时间做决定?他们从何处获取信息,以及他们重要的决策标准是什么?
本研究评估了通过问卷调查收集的关于医院选择的横断面原始数据,这些数据来自11个医学专科和3个护理级别的1925名连续住院患者,其中包括来自6个普通外科科室的438名手术患者。
四分之三的手术患者自行决定就诊医院。他们自身之前在该医院的经历是一半以上患者重要的信息来源和决策标准,此外还有亲属、门诊治疗机构以及医院声誉。
许多手术患者选择某家医院是因为他们通过之前在该医院令人满意的治疗建立起了信任。因此,治疗的专业质量对患者、其亲属和门诊治疗机构影响最大。在患者出院前积极、具体地处理并消除患者可能存在的不满情绪非常重要。