Homebound Patient and Caregiver Perceptions of Quality of Care in Home-Based Primary Care: A Qualitative Study
Homebound Patient and Caregiver Perceptions of Quality of Care in Home-Based Primary Care: A Qualitative Study
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DOI：
10.1111/jgs.14244
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发表时间：
2016-08-01
影响因子：
6.3
通讯作者：
Ritchie, Christine
中科院分区：
文献类型：
--
作者：
Shafir, Adi;Garrigues, Sarah K.;Ritchie, Christine
ObjectivesTo assess patient and carefulness perceptions of what constitutes quality care in home based primary care（HBPC）. Design横断面定性设计; semi-structured interview study.SettingAcademic home based primary care programme. ObjectivesHomebound patients（n = 13）and 10 carefulers（n = 10）receiving HBPC. MeasurementsSemi-structured interview explored experiences with a HBPC program and perception of quality care.对访谈进行了录音和转录。定性内容分析，以确定主要themes.ResultsFive大主题出现有关参与者的看法，优质的护理：访问，负担能力，能力，护理协调，目标的实现。参与者认为，可靠、一致的访问提供了安心，减少了医院和急诊室的使用。保险覆盖的计划成本和协调的跨学科团队提供的护理是积极的。人际交往能力和技术能力的供应商影响患者的供应商能力的看法。评估和帮助患者实现护理目标有助于感知quality care.ConclusionPatients和照顾者关联高品质的HBPC与周围的时钟访问负担得起的跨学科提供者具有较强的人际交往能力和技术能力。这些结果扩展了先前的研究，并与HBPC的目标一致，即全天候接触多学科团队，减少急诊室和医院的使用。HBPC计划的结构应该优化可及性、可负担性、协调的护理以及目标确定和调整。质量指标应根据患者和护理人员对护理质量的看法来创建和验证。
ObjectivesTo assess patient and caregiver perceptions of what constitutes quality care in home-based primary care (HBPC).DesignCross-sectional qualitative design; semistructured interview study.SettingAcademic home-based primary care program.ParticipantsHomebound patients (n = 13) and 10 caregivers (n = 10) receiving HBPC.MeasurementsSemistructured interviews explored experiences with a HBPC program and perceptions of quality care. Interviews were audio-recorded and transcribed. Qualitative content analysis was performed to identify major themes.ResultsFive major themes emerged related to participant perceptions of quality care: access, affordability, competency, care coordination, goal attainment. Participants felt that reliable, consistent access provided peace of mind and reduced hospital and emergency department use. Insurance coverage of program costs and coordinated care provided by an interdisciplinary team were positively regarded. Interpersonal skills and technical abilities of providers influenced patient perception of provider competency. Assessing and helping patients attain care goals contributed to a perception of quality care.ConclusionPatients and caregivers associate high-quality HBPC with around-the-clock access to affordable interdisciplinary providers with strong interpersonal skills and technical competency. These results expand on prior research and are concordant with HBPC goals of around-the-clock access to multidisciplinary teams with the goals of reduced emergency department and hospital use. HBPC programs should be structured to optimize access, affordability, coordinated care, and goal ascertainment and alignment. Quality indicators should be created and validated with these patient and caregiver views of care quality in mind.