Assuta Health Services Research Institute, Assuta Medical Centers, Tel-Aviv, Israel.
School of Health Systems Management, Netanya Academic College, Netanya, Israel.
Health Expect. 2022 Oct;25(5):2340-2354. doi: 10.1111/hex.13487. Epub 2022 Jul 14.
Active participation of patients in managing their medical treatment is a major component of the patient empowerment process and may contribute to better clinical outcomes. Patient perceptions and preferences affect the patient-physician encounter in a variety of dimensions, such as patient autonomy, freedom of choice and trust in the healthcare system. The Israeli healthcare system is mostly publicly funded, with additional private healthcare services for surgery and other medical treatments. The aim of this study was to compare the perceptions and preferences of patients in the public and private hospitals in Israel.
A cross-sectional study among 545 individuals who had surgical procedures at two hospitals in Israel (one public and one private). A structured questionnaire comprising 23 items was used to collect perceptions via personal telephone interviews. The responses were categorized into five clusters and compared by type of health services provider (public vs. private) and sociodemographic characteristics (gender, age and education level).
A hierarchical cluster analysis methodology identified five conceptual groups: trust, concern towards medical errors, dialogue between medical staff and the patient/patient's family, confidentiality and staff bias towards more informed patients, or those with supportive families. Four main themes that highlight patients' preferences were found: physical conditions, personal empowerment and perceived autonomy, patient experience and patient-provider encounter communication. Significant differences between the private and the public healthcare systems were found in four clusters: trust and patient care, patient's concerns, the extent of explanation and medical staff's commitment. Differences secondary to sociodemographic parameters were noticed: patients treated at the private hospital scored significantly higher items of trust, medical staff caring and the importance of choosing their treating surgeon, while patients treated at the public hospital scored higher staff commitment to the patient than those treated at the private hospital.
The study revealed the perceptions underlying the decisions of patients to undergo surgical procedures in public or private hospitals. Mutual learning could pave the way to better patient-physician encounters.
Patients from the two hospitals were involved in this study by responding to the questionnaire. The data presented is based on the patient's responses.
患者积极参与管理自己的治疗是患者赋权过程的重要组成部分，可能有助于改善临床结果。患者的看法和偏好会在各种方面影响医患接触，例如患者的自主性、选择自由和对医疗保健系统的信任。以色列的医疗保健系统主要由公共资金资助，另外还提供私人医疗服务，用于手术和其他医疗治疗。本研究的目的是比较以色列公立和私立医院患者的看法和偏好。
这是一项在以色列两家医院（一家公立和一家私立）进行的 545 名接受手术的个体的横断面研究。使用包含 23 个项目的结构化问卷通过个人电话访谈收集看法。将回答分为五个聚类，并按医疗服务提供者类型（公立与私立）和社会人口学特征（性别、年龄和教育水平）进行比较。
层次聚类分析方法确定了五个概念组：信任、对医疗错误的关注、医护人员与患者/患者家属之间的对话、保密性和医护人员对更知情的患者或有支持性家庭的偏见。发现了四个突出患者偏好的主要主题：身体状况、个人赋权和感知自主性、患者体验和患者-提供者接触沟通。在信任和患者护理、患者的关注、解释程度和医护人员的承诺这四个集群中，发现了公立和私立医疗保健系统之间的显著差异。由于社会人口参数的差异，注意到以下差异：在私立医院接受治疗的患者在信任、医护人员关怀和选择治疗外科医生的重要性方面的评分明显高于在私立医院接受治疗的患者，而在公立医院接受治疗的患者对医护人员对患者的承诺评分高于在私立医院接受治疗的患者。
本研究揭示了患者选择在公立或私立医院接受手术的决策背后的看法。相互学习可以为改善医患接触铺平道路。
来自两家医院的患者通过回答问卷参与了这项研究。呈现的数据基于患者的回答。
