Transcript 2 items

Factors influencing
patients’ willingness
to recommend hospital
as a place for therapy.
Polish RN4CAST pilot study results.
T. Brzostek1, L. Przewoźniak1, P.Brzyski1, M. Kózka1,
K.Gajda1, M.Cisek1, L. Aiken2, W. Sermeus3
1.
Jagiellonian University Medical College, Krakow, Poland:
Institute of Nursing and Midwifery,
Department of Medical Sociology, Chair of Epidemiology and Preventive Medicine
2.
University of Pennsylvania, USA
3.
Catholic University Leuven, Belgium
ESHMS 2010
Ghent 26-28.08.2010
Patient satisfaction
is an important indicator of Healthcare Quality
Started in 1994 yr.
The Centre of Monitoring Healthcare Quality
The primary goals
•
•
•
•
Education about Healthcare Quality for Teams from Health Care Service.
Implementation and Improvement of Accreditation Process.
Health Technology Assessment (HTA)
Monitoring three Categories of Indicators of HealthCare Quality:
medical, quality of life and patient’ satisfaction.
The PASAT program is applied by 94 hospitals and 13
outpatient clinic with accreditation of the CMHQ
Pilot study
To accomplish objectives of the RN4CAST project
(www.rn4cast.eu/en/index.php) in Poland, a pilot
study was conducted in one 24/7 acute care hospital
This presentation shows selected data of the Patient
Satisfaction
medical care.
Questionnaire
concerning
received
Aim of the pilot study
• Assessment of quality of questionnaire in terms of
patients’ ability to understand questionnaire items
and the level of responsiveness
• Assessment
of
patients
satisfaction
expressed
in terms of willingness to recommend the hospital
as a place for therapy
Material and methods
The study sample included 119 patients hospitalized
in one hospital, in internal medicine (n= 59) and
surgical
(n=66)
wards,
who
voluntary
and
anonymously agreed to participate in the study, and
filled in the questionnaire.
Survey
method,
questionnaire.
self-report
standardized
Questionnaire
The questionnaire consisted of 14 items concerning different
aspects of patients’ experiences during hospital stay:
1) respect showed by doctors (3 items) and by nurses (4 items)
2) hospital environment (2 items)
3) pharmacological management of pain (conditional, 2 items)
4) information about introduced new drug (conditional, 2 items)
5) assistance with physiological needs (conditional, 1 item)
Response format: 4-item Likert scale:
1. never, 2. sometimes, 3. usually, 4. always
6) received information about possible side effects and self-care
after leaving the hospital (2 items)
Dichotomous response format
Background variables
Type of unit, expected number of days to stay in the
hospital, self-rated health, education level,
Main outcome measure of patient satisfaction:
„Would you recommend this hospital to your friends and
family?”: definitely no, probably no, probably yes, definitely yes
Statistical analysis
Multivariate logistic regression model – 9 models for every
dimension of patient satisfaction separately
Analysis was done with SPSS 15 for Windows
Results 1
Quality of questionnaire
46% responders completed 100% of the questions
74% responders completed 90% of the questions
(missing less than 2/24 questions)
90% responders completed 80% of the questions
(missing less than 5/24 questions)
Results 2
Characteristics of the sample
Variable
Category
%
Education
Elementary
33
Secondary
53
University
14
Poor
42
Mean
17
Good
32
<=2 days
29
3-7 days
52
8+ days
19
Self-rated health (SRH)
Expected duration of the hospital stay
Results 3
Lack of doubts when recommending the hospital: 58%
Percentage of patients entirely satisfied with:
1. respect showed by doctors
70
2. respect showed by nurses
53
1+2. respect showed by medical staff
67
3. hospital environment
53
4. pharmacological management of pain c
74
5. introducing new drug c
58
4+5. pharmacology c
51
6. assistance with physiological needs c
77
summary measure of satisfaction
33
7. full information about self care after hospital leaving
77
Results 4
Odd-ratio of having doubts when recommending
the hospital related to
lack of satisfaction with:
OR
95%CI
1. respect showed by doctors
40.5
3.58 – 457
2. respect showed by nurses
3.64
0.88 – 15.1
1+2. respect showed by medical staff
8.78
1.65 - 46.8
3. hospital environment
1.95
0.58 – 6.53
4. pharmacological management of pain c
7.46
1.15 - 48.5
5. introducing new drug c
13.4
1.75 – 103
4+5. pharmacology c
31.4
1.40 - 706
6. assistance with physiological needs c
1.00
0.08 – 11.5
summary measure of satisfaction
2.77
0.36 – 21.7
Results 5
Odd-ratio of having doubts when
recommending the hospital
1. Patients who did not obtained full information about
self-care after leaving the hospital had higher odds
(OR=4,3) of having doubts in models regarding respect
from medical staff.
2. Patient who expected to stay in hospital from 3 to 7
days had lower odds (OR=0,2) of having doubts.
3. Patients with poor and mean SRH had higher odds
(OR=3,1) of having doubts.
Conclusions:
1. The questionnaire was well received, understood,
the response level was high and logical.
2. Factors influencing willingness to recommend the
hospital as a place for treatment are:
• lack of respect from medical staff, especially from
physicians,
• effective pain management
• lack of full information concerning:
• introduction of the new drugs,
• possible side effects and self-care
after leaving hospital .