Quigley Denise D, Elliott Marc N, Qureshi Nabeel, Predmore Zachary, Hays Ron D
RAND Corporation, Santa Monica, CA, USA.
RAND Corporation, Boston, MA, USA.
J Patient Exp. 2024 Oct 13;11:23743735241283204. doi: 10.1177/23743735241283204. eCollection 2024.
Patient experience is a key aspect of care quality. Since the 2007 release of the Consumer Assessment of Healthcare Providers and Systems Clinician and Group (CG-CAHPS) survey, no systematic review of factors associated with CG-CAHPS scores has been reported. We reviewed 52 peer-reviewed English language articles published in the United States using CG-CAHPS data. We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines and used the Checklist for Analytical Cross-Sectional Studies. We identified several interventions (eg, adding a care coordinator focused on chronic care management) associated with improved overall provider rating and 2 interventions (eg, peer shadow coaching) that improved provider communication scores. Studies evaluating the implementation of patient-centered medical homes or patient-reported outcomes found mixed results. We identified site-level factors (eg, better team communication) and provider-level factors (eg, physician empathy) associated with better patient experience. In contrast, patient-level factors (eg, medication adherence) found mixed associations with patient experience. Policymakers, clinicians, and healthcare leaders can leverage this evidence for quality improvement efforts and interventions supporting patient-centered care.
患者体验是医疗质量的一个关键方面。自2007年发布《医疗服务提供者和系统消费者评估临床医生及团队》(CG-CAHPS)调查以来,尚未有关于与CG-CAHPS评分相关因素的系统综述报道。我们回顾了52篇在美国发表的使用CG-CAHPS数据的同行评议英文文章。我们遵循系统综述和Meta分析的首选报告项目指南,并使用分析性横断面研究清单。我们确定了几种与整体医疗服务提供者评分提高相关的干预措施(例如,增加一名专注于慢性病管理的护理协调员)以及两种提高医疗服务提供者沟通评分的干预措施(例如同伴影子辅导)。评估以患者为中心的医疗之家实施情况或患者报告结果的研究结果不一。我们确定了与更好的患者体验相关的机构层面因素(例如,更好的团队沟通)和医疗服务提供者层面因素(例如,医生的同理心)。相比之下,患者层面因素(例如,药物依从性)与患者体验的关联则不一。政策制定者、临床医生和医疗保健领导者可以利用这些证据来开展质量改进工作,并采取支持以患者为中心的护理的干预措施。