Perceptions of Hospital Care Quality According to People Living With Multiple Long-Term Conditions: A Scoping Review.

BACKGROUND

Delivering high-quality hospital care for people with multiple long-term conditions (MLTC), defined as the co-existence of two or more chronic health conditions, is important. However, evidence on care quality from the perspective of people living with MLTC has not been synthesised. The aim of this scoping review was to identify studies investigating how people living with MLTC perceive hospital care quality and to summarise key concepts and gaps in the evidence base.

METHODS

Systematic searches of five databases to identify all eligible studies published up until March 2024 were undertaken and supplemented by citation tracking. Peer-reviewed articles featuring people with MLTC's perceptions of the quality of 'usual' care in hospitals were eligible for inclusion. All records were screened independently by two reviewers.

RESULTS

Of the 3178 titles and abstracts screened, 17 papers were eligible for inclusion (9 qualitative, 7 quantitative and 1 mixed-methods). Studies highlighted an unmet desire for holistic interdisciplinary care (n = 4), prioritisation of inpatients' acute conditions over long-term conditions (n = 2), barriers to patient engagement (n = 3) and insufficient discharge planning (n = 3).

CONCLUSION

Existing studies that have investigated how people living with MLTC perceive the quality of their hospital care are diverse. However, all included studies point to ways in which hospital care for people with MLTC could be improved. The review highlights a need for studies including people of a wider range of ages, mixed-methods studies and studies that focus on under-researched elements of care quality, such as safety and preventative care.

PATIENT OR PUBLIC CONTRIBUTION

There have been regular opportunities for engagement with the ADMISSION research collaborative's Patient Advisory Group (PAG), a group of patients and carers with lived experience of multiple long-term conditions, who meet every 4 months. At these meetings, hospital care quality (and patients' perception thereof) has been a recurring theme, which encouraged the conceptualisation of this review. The PAG had no further direct involvement in the conduct of this review.