Quality and Coordination of Care for Patients With Multiple Conditions: Results From an International Survey of Patient Experience
Quality and Coordination of Care for Patients With Multiple Conditions: Results From an International Survey of Patient Experience
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DOI：
10.1177/0163278710375695
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发表时间：
2010-09-01
影响因子：
2.9
通讯作者：
Schneider, Eric C.
中科院分区：
文献类型：
--
作者：
Burgers, Jako S.;Voerman, Gerlienke E.;Schneider, Eric C.
先前使用临床表现测量的研究表明，患有多种慢性疾病的患者的护理质量并不比其他患者差。本文介绍了来自八个国家的8，973名慢性病成年人的患者报告的医疗保健经验，使用电话调查数据。我们设计了一个“发病率评分”，结合了疾病的数量和报告的健康状况。高发病率得分的受访者报告较少有利的经验，与低发病率得分相比，与护理协调。他们还报告了整体护理质量的较低评级。个体医生报告的经验无差异。比较合并症的类型，慢性肺病和精神健康问题与高血压、心脏病、糖尿病、关节炎和癌症的评分相关性较低。本研究的意义和局限性进行了讨论的背景下，医疗保健改革。绩效工资计划需要考虑到慢性病，以避免惩罚那些照顾大部分慢性病患者的医生。
Previous studies using clinical performance measures suggest that quality of care for patients with multiple chronic conditions is not worse than that for others. This article presents patient-reported experiences of health care among 8,973 of chronically ill adults from eight countries, using telephone survey data. We designed a "morbidity score'' combining the number of conditions and reported health status. Respondents with high morbidity scores reported less favorable experience with coordination of care compared to those with low morbidity scores. They also reported lower ratings of overall quality of care. There were no differences in reported experience with the individual physicians. Comparing type of comorbidity, chronic lung, and mental health problems were associated with lower ratings than hypertension, heart disease, diabetes, arthritis, and cancer. The implications and limitations of this study are discussed in the context of health care reform. Pay-for-performance programs need to account for chronic conditions to avoid penalizing physicians who care for larger shares of such patients.