Leuven Institute for Healthcare Policy, KU Leuven - University of Leuven, Belgium; Department of Orthopaedics, University Hospitals Leuven, Belgium.
Leuven Institute for Healthcare Policy, KU Leuven - University of Leuven, Belgium.
Health Policy. 2021 Dec;125(12):1565-1573. doi: 10.1016/j.healthpol.2021.10.008. Epub 2021 Oct 14.
Collaboration between policymakers, patients and healthcare workers in hospital quality of care policy setting can improve the integration of new initiatives. The aim of this study was to quantify preferences for various characteristics of a future quality policy in a broad group of stakeholders.
450 policymakers, clinicians, nurses, patient representatives and hospital board members in Flanders (Belgium) participated in five discrete choice experiments (DCE) on quality control, quality improvement, inspection, patient incidents and transparency. For each DCE, various attributes and levels were defined from a literature review and interviews with 12 international quality and patient safety experts.
For the attributes with the highest relative importance, participants exhibited a strong preference for quality control by an independent national organization and coordination of quality improvement initiatives at the level of hospital networks. The individual hospital was chosen over the government for setting up an action plan following patient complaints. Respondents also strongly preferred mandatory reporting of severe patient incidents and transparency by publicly reporting quality indicators at the hospital level.
A future quality model should focus on a multicomponent approach with external quality control, improvement actions on hospital network level and public transparency. DCEs provide an opportunity to incorporate the attitudes and views for individual components of a new policy recommendation.
政策制定者、患者和医疗机构工作人员在医院质量护理政策制定方面的合作，可以提高新举措的整合程度。本研究的目的是量化广大利益相关者对未来质量政策的各种特征的偏好。
在比利时佛兰德地区，450 名政策制定者、临床医生、护士、患者代表和医院董事会成员参加了五次关于质量控制、质量改进、检查、患者事件和透明度的离散选择实验（DCE）。对于每项 DCE，从文献综述和与 12 名国际质量和患者安全专家的访谈中定义了各种属性和水平。
对于具有最高相对重要性的属性，参与者表现出对由独立的国家组织进行质量控制以及在医院网络层面协调质量改进举措的强烈偏好。在制定患者投诉后的行动计划方面，选择了医院而不是政府。受访者还强烈倾向于强制性报告严重的患者事件，并通过公开报告医院层面的质量指标来提高透明度。
未来的质量模型应侧重于多组件方法，包括外部质量控制、在医院网络层面采取改进措施和公开透明度。DCE 提供了一个机会，可以将新政策建议的各个组成部分的态度和观点纳入其中。
