A Mixed-Methods Analysis of Patient Reviews of Hospital Care in England: Implications for Public Reporting of Health Care Quality Data in the United States
A Mixed-Methods Analysis of Patient Reviews of Hospital Care in England: Implications for Public Reporting of Health Care Quality Data in the United States
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DOI：
10.1016/s1553-7250(13)39003-5
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发表时间：
2013-01-01
影响因子：
2.3
通讯作者：
Lindenauer, Peter K.
中科院分区：
文献类型：
--
作者：
Lagu, Tara;Goff, Sarah L.;Lindenauer, Peter K.
背景：在美国，患者阅读和撰写关于医院的叙述性评论的机会有限。相比之下，英国国家医疗服务体系（NHS）鼓励患者在其质量报告网站NHS Choices上向医院提供反馈。的范围和内容的叙述feedbacks.Methods：所有NHS医院超过10个评论张贴在NHS的选择被包括在一个横截面的混合方法（定性和定量）分析患者的评论20随机选择hospital.Results：最终样本包括264家医院和2,640名患者的结构化问题的反应。对随机抽取的20家医院的200篇综述进行了进一步的定量和定性分析。关于临床医生和工作人员的评论很常见（179 [90%]），绝大多数是积极的，其中149（83%）有利于工人。在200篇综述中，有124篇（62%）患者对医院护理的技术方面进行了评论，包括护理质量、伤害、错误和不正确的医疗记录或出院文件。在51篇（26%）医院评论中描述了感知的医疗错误。关于医院设施的评论出现在一半（52%）的评论中，描述了医院的清洁度，食物，停车场和设施。讨论：NHS选择代表了第一个政府运行的倡议，使任何病人提供有关医院护理的叙述反馈。审查的领域似乎与现有满意度调查所涵盖的领域相似，但也包括此类调查不太可能披露的详细反馈。因此，在线叙事评论可以为消费者（患者）和医院提供有用的补充信息，特别是当与系统收集的患者体验数据相结合时。
Background: In the United States patients have limited opportunities to read and write narrative reviews about hospitals. In contrast, the National Health Service (NHS) in England encourages patients to provide feedback to hospitals on their quality-reporting website, NHS Choices. The scope and content of the narrative feedback was studied.Methods: All NHS hospitals with more than 10 reviews posted on NHS Choices were included in a cross-sectional mixed-methods (qualitative and quantitative) analysis of patients' reviews of 20 randomly selected hospitals.Results: The final sample consisted of 264 hospitals and 2,640 patient responses to structured questions. All 200 reviews from the 20 hospitals randomly selected were subjected to further quantitative and qualitative analysis. Comments about clinicians and staff were common (179 [90%]) and overwhelmingly positive, with 149 (83%) favorable to workers. In 124 (62%) of the 200 reviews, patients commented on technical aspects of hospital care, including quality of care, injuries, errors, and incorrect medical record or discharge documentation. Perceived medical errors were described in 51 (26%) hospital reviews. Comments about the hospital facility appeared in half (52%) of reviews, describing hospital cleanliness, food, parking, and amenities. Hospitals replied to 56% of the patient reviews.Discussion: NHS Choices represents the first government-run initiative that enables any patient to provide narrative feedback about hospital care. Reviews appear to have similar domains to those covered in existing satisfaction surveys but also include detailed feedback that would be unlikely to be revealed by such surveys. Online narrative reviews can therefore provide useful and complementary information to consumers (patients) and hospitals, particularly when combined with systematically collected patient experience data.