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儿科住院患者体验的驱动因素:对加拿大艾伯塔省儿科住院患者体验调查的病例组合因素的回顾性分析。

Drivers of paediatric inpatient experience: retrospective analysis of casemix factors for the Alberta Paediatric Inpatient Experience Survey in Alberta, Canada.

机构信息

Paediatrics and Community Health Sciences, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.

Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.

出版信息

BMJ Open. 2022 May 12;12(5):e048207. doi: 10.1136/bmjopen-2020-048207.

Abstract

OBJECTIVE

In Alberta, the Alberta Paediatric Inpatient Experience Survey (APIES) is used as a proxy-reported measure of paediatric experience. To our knowledge, the influence of casemix factors on patient experience as measured by paediatric patient experience surveys have not been reported within Canadian paediatric samples. In this paper, we sought to determine the patient and respondent factors associated with paediatric inpatient experiences in Alberta, Canada.

DESIGN

Retrospective analysis of patient experience survey data.

SETTING

Inpatiet acute care hospitals in Alberta, Canada.

INTERVENTION AND MAIN OUTCOME MEASURES

Retrospective analyses were conducted using APIES surveys linked with eligible inpatient records (n=6262). Descriptive statistics were reported. χ tests were performed to assess distribution of casemix between general and paediatric hospitals. Logistic regression was performed with overall hospital experience as the dependent variable with casemix and hospital variables as independent variables.

RESULTS

Casemix characteristics were unevenly distributed between general and paediatric hospitals. Compared with reference categories, older respondents, healthier patients and treatment at paediatric facilities had increased odds of providing most-positive ratings. Increased respondent education was associated with decreased odds of providing most-positive ratings. Likelihood-ratio tests showed that most casemix variables improved model fit, except for respondent relationship to the patient.

CONCLUSIONS

To improve reports of paediatric inpatient experience, administrators and providers require reliable and comparable measurement. Both the Child Hospital Consumer Assessment of Healthcare Providers and Systems and other measures of patient and family experience need to consider patient and respondent characteristics when interpreting results. Considered with other research from patient experience in Alberta, we discuss future directions and quality improvement implications.

摘要

目的

在艾伯塔省,使用艾伯塔省儿科住院患者体验调查(APIES)作为儿科体验的代理报告衡量标准。据我们所知,在加拿大儿科样本中,尚未报告病例组合因素对儿科患者体验调查衡量的患者体验的影响。在本文中,我们旨在确定与艾伯塔省加拿大儿科住院患者体验相关的患者和受访者因素。

设计

回顾性分析患者体验调查数据。

地点

艾伯塔省加拿大住院急性护理医院。

干预措施和主要观察指标

使用与合格住院记录(n=6262)相关的 APIES 调查进行回顾性分析。报告描述性统计数据。进行 χ 检验以评估普通医院和儿科医院之间的病例组合分布。将总体医院体验作为因变量,将病例组合和医院变量作为自变量进行逻辑回归。

结果

病例组合特征在普通医院和儿科医院之间分布不均。与参考类别相比,年龄较大的受访者、病情较轻的患者以及在儿科机构接受治疗的患者,对提供最积极评价的可能性更高。受访者教育程度增加与提供最积极评价的可能性降低有关。似然比检验表明,除了受访者与患者的关系外,大多数病例组合变量都改善了模型拟合度。

结论

为了改善儿科住院患者体验报告,管理人员和提供者需要可靠和可比的衡量标准。儿童医院医疗保健提供者和系统评估以及其他患者和家庭体验衡量标准在解释结果时都需要考虑患者和受访者的特征。结合艾伯塔省患者体验的其他研究,我们讨论了未来的方向和质量改进的影响。

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How to practice person-centred care: A conceptual framework.如何实践以患者为中心的护理:概念框架。
Health Expect. 2018 Apr;21(2):429-440. doi: 10.1111/hex.12640. Epub 2017 Nov 19.

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