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Derriennic J, Nabbe P, Barais M, Le Goff D, Pourtau T, Penpennic B, Le Reste JY. A systematic literature review of patient self-assessment instruments concerning quality of primary care in multiprofessional clinics. Fam Pract 2022; 39:951-963. [PMID: 35230419 PMCID: PMC9508876 DOI: 10.1093/fampra/cmac007] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Quality of care remains a priority issue and is correlated with patient experience. Measuring multidimensional patient primary care experiences in multiprofessional clinics requires a robust instrument. Although many exist, little is known about their quality. OBJECTIVE To identify patient perception instruments in multiprofessional primary care and evaluate their quality. METHODS Systematic review using Medline, Pascal, PsycINFO, Google Scholar, Cochrane, Scopus, and CAIRN. Eligible articles developed, evaluated, or validated 1 or more self-assessment instruments. The instruments had to measure primary care delivery, patient primary care experiences and assess at least 3 quality-of-care dimensions. The COnsensus-based Standards for the selection of health status Measurement Instruments (COSMIN) checklist was used to assess methodological quality of included studies. Instrument measurement properties were appraised using 3 possible quality scores. Data were combined to provide best-evidence synthesis based on the number of studies, their methodological quality, measurement property appraisal, and result consistency. Subscales used to capture patient primary care experiences were extracted and grouped into the 9 Institute of Medicine dimensions. RESULTS Twenty-nine articles were found. The included instruments captured many subscales illustrating the diverse conceptualization of patient primary care experiences. No included instrument demonstrated adequate validity and the lack of scientific methodology for assessing reliability made interpreting validity questionable. No study evaluated instrument responsiveness. CONCLUSION Numerous patient self-assessment instruments were identified capturing a wide range of patient experiences, but their measurement properties were weak. Research is required to develop and validate a generic instrument for assessing quality of multiprofessional primary care. TRIAL REGISTRATION Not applicable.
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Affiliation(s)
- Jérémy Derriennic
- Department of General Practice, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France.,ER 7479 SPURBO, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France
| | - Patrice Nabbe
- Department of General Practice, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France.,ER 7479 SPURBO, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France
| | - Marie Barais
- Department of General Practice, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France.,ER 7479 SPURBO, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France
| | - Delphine Le Goff
- Department of General Practice, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France.,ER 7479 SPURBO, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France
| | - Thomas Pourtau
- Department of General Practice, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France
| | - Benjamin Penpennic
- Department of General Practice, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France
| | - Jean-Yves Le Reste
- Department of General Practice, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France.,ER 7479 SPURBO, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR, France
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Patients' and physicians' perspectives and experiences on the quality of medical consultations: a qualitative study. INT J EVID-BASED HEA 2021; 18:247-255. [PMID: 31714340 DOI: 10.1097/xeb.0000000000000210] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM Medical consultation is not only one of the most important steps in disease diagnosis and patient treatment, but also every patient's right. The purpose of this review was to explore patients' and physicians' perspectives and experiences of the quality of medical consultations. METHODS A qualitative interview study was carried out in outpatient clinics. A combination of face-to-face and telephone interviews was used due to the geographical spread of the respondents. Interviews were recorded and transcribed verbatim. Thematic descriptive analysis was used to interpret the data. Eligible physicians (n = 21) and patients (n = 27) were invited to take part in a semistructured interview to explore the views, perceptions, and experiences of patients on various factors affecting the quality of medical consultations. RESULTS The consultation quality was categorized into three topics: structure quality, process quality, and outcome quality. Data synthesis identified the following major themes for structure quality of consultations: administrative-organizational quality (with eight subthemes), physical environment quality (with six subthemes), and educational quality (with three subthemes). In addition, process quality was categorized into two major themes: examination quality (with nine subthemes) and interpersonal quality (with 13 subthemes). Outcome quality consisted of three major themes: patient satisfaction (with four subthemes), clinical outcomes (with two subthemes), and organizational outcomes (with three subthemes). CONCLUSION Medical consultation plays a central role in the quality and effectiveness of the received health care. Using the indicators of consultation quality improvement can develop physicians' clinical competence and skills. Furthermore, decision-makers can use them to monitor and evaluate physicians' performance.
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Krztoń-Królewiecka A, Oleszczyk M, Windak A. Do Polish primary care physicians meet the expectations of their patients? An analysis of Polish QUALICOPC data. BMC FAMILY PRACTICE 2020; 21:118. [PMID: 32576153 PMCID: PMC7313208 DOI: 10.1186/s12875-020-01190-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/16/2019] [Accepted: 06/15/2020] [Indexed: 11/24/2022]
Abstract
Background Meeting the expectations of patients is one of the most crucial criteria when assessing the quality of a healthcare system. This study aimed to compare the expectations and experiences of patients of primary care in Poland and to identify key patient characteristics affecting these outlooks. Methods The study was performed within the framework of the international Quality and Costs of Primary Care in Europe (QUALICOPC) cross-sectional, questionnaire-based study. In Poland, a nationally representative sample of 2218 patients were recruited to take part in the study. As a study tool, we used data from two of four QUALICOPC questionnaires: “Patient Experience” and “Patient Values”. Results Patients’ expectations were fulfilled in all study areas: accessibility, continuity, quality of care, and equity. We observed that the highest-met expectations indexes were in the area of quality of care, while the lowest, but still with a positive value, were in the area of accessibility. Patient-doctor communication was the aspect most valued by study participants. Elements of the patient’s own level of engagement during the consultation were ranked as less essential. Conclusions Comparing patient experiences to their values allows us to identify areas for improvement that are prioritized by patients. Accessibility is recognized as the most important area by Polish patients, simultaneously showing the highest level of patient-perceived improvement potential. Interpersonal care is another domain, in which the needs of patients are satisfied but are also relatively high. Strong clinician-patient relationships seem to be a priority in patients’ expectations. The continuous efforts in interpersonal communication skills training for primary care physicians should be upgraded.
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Affiliation(s)
- Anna Krztoń-Królewiecka
- Department of Family Medicine, Jagiellonian University Medical College, 4 Bochenska Street, 31-061, Krakow, Poland. .,The College of Family Physicians in Poland, 1 Muranowska Street, 00-209, Warsaw, Poland.
| | - Marek Oleszczyk
- Department of Family Medicine, Jagiellonian University Medical College, 4 Bochenska Street, 31-061, Krakow, Poland.,The College of Family Physicians in Poland, 1 Muranowska Street, 00-209, Warsaw, Poland
| | - Adam Windak
- Department of Family Medicine, Jagiellonian University Medical College, 4 Bochenska Street, 31-061, Krakow, Poland.,The College of Family Physicians in Poland, 1 Muranowska Street, 00-209, Warsaw, Poland
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Oleszczyk M, Krztoń-Królewiecka A, Schäfer WLA, Boerma WGW, Windak A. Experiences of adult patients using primary care services in Poland - a cross-sectional study in QUALICOPC study framework. BMC FAMILY PRACTICE 2017; 18:93. [PMID: 29166872 PMCID: PMC5700756 DOI: 10.1186/s12875-017-0665-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/15/2017] [Indexed: 11/14/2022]
Abstract
Background Patients as real healthcare system users are important observers of primary care and are able to provide reliable information about the quality of care. The aim of this study was to explore the patients’ experiences and their level of satisfaction with the process and outcomes of care provided by primary care physicians in Poland and to identify the characteristics of the patients, their physicians, and facilities associated with patient satisfaction. Methods The study is based on data from the Polish part of the Quality and Costs of Primary Care in Europe (QUALICOPC) cross-sectional, questionnaire-based study. In Poland, a nationally representative sample of 220 PC physicians and 1980 of their patients were recruited to take part in the study. As a study tool we used 3 out of 4 QUALICOPC questionnaires: “Patient Experience”, “PC Physician” and “Fieldworker” questionnaires. Results The areas of the best quality perceived by Polish PC patients are: equity, accessibility of care and quality of service. Coordination and comprehensiveness of care are evaluated relatively worse. The patients’ and their physicians’ characteristics have a limited influence on patient satisfaction and experiences with Polish primary care. Conclusions Primary health care in Poland is of good overall quality as perceived by the patients. Study participants were at most satisfied with accessibility and equity of care and less satisfied with coordination and comprehensiveness of care. Longer patient-doctor relationship and older age of patients were found as the most influential determinants of higher satisfaction. However, variables used in this study poorly explain the overall level of satisfaction. Further research is needed to identify the other determinants of patient satisfaction in the Polish population. Rural practices deserve additional attention due to highest proportions of both extremely satisfied and dissatisfied patients. Electronic supplementary material The online version of this article (10.1186/s12875-017-0665-6) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Marek Oleszczyk
- Department of Family Medicine, Chair of Internal Medicine and Gerontology, Jagiellonian University Medical College, 4 Bochenska St., 31-061, Krakow, Poland.
| | - Anna Krztoń-Królewiecka
- Department of Family Medicine, Chair of Internal Medicine and Gerontology, Jagiellonian University Medical College, 4 Bochenska St., 31-061, Krakow, Poland
| | - Willemijn L A Schäfer
- NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500, BN, Utrecht, the Netherlands
| | - Wienke G W Boerma
- NIVEL, Netherlands Institute for Health Services Research, PO Box 1568, 3500, BN, Utrecht, the Netherlands
| | - Adam Windak
- Department of Family Medicine, Chair of Internal Medicine and Gerontology, Jagiellonian University Medical College, 4 Bochenska St., 31-061, Krakow, Poland
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Vaillancourt S, Seaton MB, Schull MJ, Cheng AHY, Beaton DE, Laupacis A, Dainty KN. Patients' Perspectives on Outcomes of Care After Discharge From the Emergency Department: A Qualitative Study. Ann Emerg Med 2017; 70:648-658.e2. [PMID: 28712607 DOI: 10.1016/j.annemergmed.2017.05.034] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Revised: 04/24/2017] [Accepted: 05/24/2017] [Indexed: 11/30/2022]
Abstract
STUDY OBJECTIVE Much effort has been expended to understand what care experiences patients value in the emergency department (ED), yet little is known about which outcomes patients value after ED care. Our goal is to define outcomes of ED care that are valued by patients discharged from the ED, with the goal of informing the development of a patient-reported outcome measure for ED care. METHODS We conducted qualitative semistructured interviews with patients recruited during their care at 1 of 2 EDs and interviewed in either English or French 1 to 9 days after their visit. Patients who were hospitalized were excluded. Interviews focused on perceived outcomes of care since the ED visit and expectations of care before the ED visit. We identified themes with standard descriptive content analysis techniques and a modified version of the constant comparative method, drawing on grounded theory methods. RESULTS We interviewed 46 patients in English (n=38) or French (n=8). Participants with diverse reasons for seeking care appeared to value common outcomes from ED care that centered around 4 themes: understanding the cause and expected trajectory of their symptoms; reassurance; symptom relief; and having a plan to manage their symptoms, resolve their issue, or pursue further medical care. These themes were also reflected in the expectations participants recalled having when they decided to seek care in the ED. CONCLUSION The 4 outcomes defined constitute areas for improvement and will inform the development of an ED patient-reported outcome questionnaire. Consideration should be given to measuring patient-reported outcomes separately from patient experience.
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Affiliation(s)
- Samuel Vaillancourt
- Department of Emergency Medicine, St. Michael's Hospital; Li Ka Shing Knowledge Institute, St. Michael's Hospital; Department of Medicine, University of Toronto.
| | | | - Michael J Schull
- Department of Medicine, University of Toronto; Institute for Health Policy, Management and Evaluation, University of Toronto; Department of Emergency Medicine, Sunnybrook Health Sciences Centre, and the Institute for Clinical Evaluative Sciences
| | - Amy H Y Cheng
- Department of Emergency Medicine, St. Michael's Hospital; Department of Medicine, University of Toronto
| | - Dorcas E Beaton
- Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Health Policy, Management and Evaluation, University of Toronto; Department of Occupational Science and Occupational Therapy, University of Toronto; Institute for Work & Health
| | - Andreas Laupacis
- Li Ka Shing Knowledge Institute, St. Michael's Hospital; Department of Medicine, University of Toronto
| | - Katie N Dainty
- Li Ka Shing Knowledge Institute, St. Michael's Hospital; Institute for Health Policy, Management and Evaluation, University of Toronto
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Kurpas D, Szwamel K, Mroczek B. Quality of Care for Patients with Chronic Respiratory Diseases: Data for Accreditation Plan in Primary Healthcare. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 910:71-85. [PMID: 26820726 DOI: 10.1007/5584_2015_203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
There are scarce reports in the literature on factors affecting the assessment of the quality of care for patients with chronic respiratory diseases. Such information is relevant in the accreditation process on implementing the healthcare. The study group consisted of 133 adult patients with chronic respiratory diseases and 125 adult patients with chronic non-respiratory diseases. In the present study, the level of satisfaction from healthcare provided by the primary healthcare unit, disease acceptance, quality of life, health behaviors, and met needs were examined, as well as associations between variables with the use of correspondence analysis. The results are that in patients with chronic respiratory diseases an increase in satisfaction depends on the improvement of well-being in the mental sphere. The lack of problems with obtaining a referral to a specialist and a higher level of fulfilled needs also have a positive effect. Additionally, low levels of satisfaction should be expected in those patients with chronic respiratory diseases who wait for an appointment in front of the office for a long time, report problems with obtaining a referral to additional tests, present a low level of health behaviors, and have a low index of benefits.
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Affiliation(s)
- Donata Kurpas
- Department of Family Medicine, Wroclaw Medical University, 1 Syrokomli St., 51-141, Wroclaw, Poland. .,Opole Medical School, 68 Katowicka St., 45-060, Opole, Poland.
| | - Katarzyna Szwamel
- Independent Public Healthcare Center, Hospital Emergency Ward and Admissions, 2 Roosevelta St., 47-200, Kędzierzyn- Koźle, Poland
| | - Bożena Mroczek
- Department of Humanities in Medicine, Faculty of Health Sciences, 11 Gen. Dezyderego Chłapowskiego St., 70-103, Szczecin, Poland
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