Hearnshaw H, Baker R, Cooper A, Eccles M, Soper J
Eli Lilly National Clinical Audit Centre, Department of General Practice and Primary Health Care, University of Leicester, UK.
Fam Pract. 1996 Feb;13(1):52-8. doi: 10.1093/fampra/13.1.52.
Patient views are important in the evaluation of the quality of health care. The use of surveys needs to be evaluated to determine their cost-effectiveness and benefits.
To determine the costs of conducting patient opinion surveys in general practice and to find out how effective patient surveys are in stimulating changes which are beneficial for patient care.
Postal questionnaire to all 102 medical audit advisory groups (MAAGs) and 98 family health services authorities (FHSAs) in England and Wales, followed by postal questionnaire to 302 general practices reported to have conducted surveys, sampled by the type or questionnaire used. Numbers of MAAGs and FHSAs reporting surveys in general practice; types of questionnaire used; estimated costs; changes made; and benefits identified were measured.
Eighty-five (83%) MAAGs and 75 (77%) FHSAs responded. One hundred and fifty-four (96%) of MAAGs or FHSAs reported survey activity. Types of questionnaire used were 1) designed by the practice, 2) designed by the MAAG or FHSA, possibly in collaboration with a practice, or 3) standard 'off-the-shelf'. One hundred and thirty-three (44%) practices responded. Total costs to a practice of conducting a survey ranged from nothing to over 2200 Pounds. Questionnaires designed by the practice are likely to be more costly than other designs. Some practices had surveys provided free of charge by MAAG or FHSA. Sixty-one per cent of practices said changes had been implemented and a further 22% of practices said changes were planned. The most common change was to appointment systems. Benefits were identified for patients, staff, the practice, the MAAG or FHSA and the NHS. Surveys also brought benefits in relationships and understanding. Only 8.2% of practices felt the costs of surveys outweighed the benefits.
Many practices are surveying patients' opinions. Surveys can be costly but MAAGs and FHSAs can provide expertise and resources. Surveys using any of the types of questionnaire are likely to lead to changes and identifiable benefits. Benefits of surveys are perceived by the majority of practices to outweigh the costs.
患者的观点在医疗保健质量评估中很重要。需要对调查的使用进行评估，以确定其成本效益和益处。
确定在全科医疗中开展患者意见调查的成本，并了解患者调查在促进有利于患者护理的变革方面的效果如何。
向英格兰和威尔士的所有102个医疗审计咨询小组（MAAGs）和98个家庭健康服务机构（FHSAs）邮寄问卷，随后向据报告开展过调查的302个全科医疗诊所邮寄问卷，根据所使用的问卷类型进行抽样。统计报告在全科医疗中开展调查的MAAGs和FHSAs的数量；所使用的问卷类型；估计成本；所做出的改变；以及所确定的益处。
85个（83%）MAAGs和75个（77%）FHSAs做出了回应。154个（96%）MAAGs或FHSAs报告了调查活动。所使用的问卷类型有：1）由诊所设计；2）由MAAG或FHSA设计，可能与某个诊所合作；或3）标准的“现成”问卷。133个（44%）诊所做出了回应。一个诊所开展一项调查的总成本从无到超过2200英镑不等。由诊所设计的问卷可能比其他设计成本更高。一些诊所的调查由MAAG或FHSA免费提供。61%的诊所表示已经实施了变革，另有22%的诊所表示计划进行变革。最常见的变革是预约系统。确定了对患者、工作人员、诊所、MAAG或FHSA以及国民保健服务体系（NHS）的益处。调查在关系和理解方面也带来了好处。只有8.2%的诊所认为调查成本超过了益处。
许多诊所正在调查患者的意见。调查可能成本高昂，但MAAGs和FHSAs可以提供专业知识和资源。使用任何一种问卷类型的调查都可能导致变革和可识别的益处。大多数诊所认为调查的益处超过了成本。
