Public Health, Korle Bu Teaching Hospital, Accra, Ghana
Quality Management Unit, Korle Bu Teaching Hospital, Accra, Ghana.
BMJ Open Qual. 2024 Jun 10;13(2):e002683. doi: 10.1136/bmjoq-2023-002683.
Patients determine quality of healthcare by their perception of the gap between the healthcare they experience/receive and that which they expect. This can be influenced by the ability of healthcare staff to adequately communicate information about the healthcare provided. This study assessed the level of relevance of meeting patients' information needs with respect to their assessment of healthcare quality in a private hospital's general outpatient department in Ghana.
Study design was cross-sectional using exit self-administered questionnaires among 390 outpatients. Healthcare quality was measured using a modified form of the Service Quality model gap analysis (gap between experience and expectations). A negative gap signifies unmet patient expectations. Microsoft Excel and Stata V.15.0 were used for analysis using t-test and multiple linear regression. A p value ≤0.05 denotes statistical significance.
The mean percentage of patients' expectations of quality of healthcare was 87.6% (SE 0.031), while patient experience was 86.0% (SE 0.029), with a significant negative gap of -0.08 (p<0.002). Their highest expectation of the quality of healthcare was for their information needs to be met, with a mean score of 4.44 (SE 0.03). Two of the four items under the information needs dimension that showed no statistically significant gaps were 'saying all their problems' (gap=0.00; p<0.9) and 'explanation of treatment/medications' (gap=0.01; p<0.6). Those with statistically significant negative gaps were 'explanation of investigations and procedures' (gap=-0.18; p<0.0001) and 'explanation of the diagnoses' (gap=-0.11; p<0.02), signifying unmet expectations.
The outpatient's greatest need for quality healthcare in this study was for their information needs to be met. Providing information on patient diagnoses and investigations are the areas least likely to be adequately communicated to patients.
患者通过体验/接受的医疗保健与他们预期的医疗保健之间的差距来确定医疗保健质量。这可能会受到医护人员充分传达所提供医疗保健信息的能力的影响。本研究评估了加纳一家私立医院普通门诊部的医疗保健质量，以评估满足患者信息需求与他们对医疗保健质量评估之间的相关性。
这是一项横断面研究，使用 390 名门诊患者的退出自我管理问卷。使用服务质量模型差距分析（体验与期望之间的差距）的修正形式来衡量医疗保健质量。负差距表示未满足患者的期望。使用 Microsoft Excel 和 Stata V.15.0 进行分析，使用 t 检验和多元线性回归。p 值≤0.05 表示具有统计学意义。
患者对医疗保健质量的期望的平均百分比为 87.6%（SE 0.031），而患者体验为 86.0%（SE 0.029），存在显著的负差距-0.08（p<0.002）。他们对医疗保健质量的最高期望是满足他们的信息需求，平均得分为 4.44（SE 0.03）。信息需求维度下的四个项目中有两个没有显示出统计学上的差距，分别是“说出他们所有的问题”（差距=0.00；p<0.9）和“解释治疗/药物”（差距=0.01；p<0.6）。有统计学意义的负差距的两个项目是“解释检查和程序”（差距=-0.18；p<0.0001）和“解释诊断”（差距=-0.11；p<0.02），表示未满足期望。
在这项研究中，门诊患者对医疗保健质量的最大需求是满足他们的信息需求。提供有关患者诊断和检查的信息是最不可能向患者充分传达的领域。
