Patient complaints in healthcare systems: a systematic review and coding taxonomy.
Patient complaints in healthcare systems: a systematic review and coding taxonomy.
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DOI：
10.1136/bmjqs-2013-002437
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发表时间：
2014-08
影响因子：
5.4
通讯作者：
Roberts J
中科院分区：
文献类型：
--
作者：
Reader TW;Gillespie A;Roberts J
患者投诉已被确定为监测和改善患者安全的宝贵资源。本文对有关患者投诉的文献进行了批判性的回顾，并综合了这些研究成果以开发一种用于分析患者投诉的编码分类法。对PubMed、Science Direct和Medline数据库进行了系统调查，以确定患者投诉研究。如果出版物报告了关于患者发起的投诉内容的初步量化数据，则包括在内。数据被提取并综合在(1)基本研究特征；(2)方法细节；(3)患者抱怨的问题上。纳入59项研究，报告88例 069患者投诉。患者投诉编码方法差异很大(例如，将单一或多个原因归因于投诉)。总共有113个 551问题被发现是患者投诉的基础。使用205种不同的分析代码对这些代码进行了分析，这些代码组合在一起代表了投诉问题的29个子类。最常被投诉的问题是“治疗”(15.6%)和“沟通”(13.7%)。为了开发患者投诉编码分类，子类别被按主题分组为七个类别，然后是三个概念上不同的域。第一个领域涉及临床护理安全和质量的投诉(占投诉问题的33.7%)，第二个领域涉及医疗机构的管理层(35.1%)，第三个领域涉及医护人员与患者关系的问题(29.1%)。对患者投诉的严格分析将有助于识别患者安全方面的问题。要做到这一点，有必要将分析和解释病人投诉的方式标准化。通过综合59项患者投诉研究的数据，我们提出了一种编码分类法，以支持未来在患者投诉数据分析方面的研究和实践。
Patient complaints have been identified as a valuable resource for monitoring and improving patient safety. This article critically reviews the literature on patient complaints, and synthesises the research findings to develop a coding taxonomy for analysing patient complaints. The PubMed, Science Direct and Medline databases were systematically investigated to identify patient complaint research studies. Publications were included if they reported primary quantitative data on the content of patient-initiated complaints. Data were extracted and synthesised on (1) basic study characteristics; (2) methodological details; and (3) the issues patients complained about. 59 studies, reporting 88 069 patient complaints, were included. Patient complaint coding methodologies varied considerably (eg, in attributing single or multiple causes to complaints). In total, 113 551 issues were found to underlie the patient complaints. These were analysed using 205 different analytical codes which when combined represented 29 subcategories of complaint issue. The most common issues complained about were ‘treatment’ (15.6%) and ‘communication’ (13.7%). To develop a patient complaint coding taxonomy, the subcategories were thematically grouped into seven categories, and then three conceptually distinct domains. The first domain related to complaints on the safety and quality of clinical care (representing 33.7% of complaint issues), the second to the management of healthcare organisations (35.1%) and the third to problems in healthcare staff–patient relationships (29.1%). Rigorous analyses of patient complaints will help to identify problems in patient safety. To achieve this, it is necessary to standardise how patient complaints are analysed and interpreted. Through synthesising data from 59 patient complaint studies, we propose a coding taxonomy for supporting future research and practice in the analysis of patient complaint data.