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Parker E, Banfield M. Consumer Perspectives on Anxiety Management in Australian General Practice. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095706. [PMID: 35565105 PMCID: PMC9103805 DOI: 10.3390/ijerph19095706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/03/2022] [Accepted: 05/04/2022] [Indexed: 11/16/2022]
Abstract
The aim of the current study was to explore consumer views on the management of anxiety in general practice, which is often the first service from which a consumer seeks professional support. We used a mixed methods survey to explore three broad research questions: (1) what are consumer experiences of anxiety management in general practice, (2) what do consumers prioritise when considering treatment for anxiety and what are their preferences for type of treatment, and (3) how do consumers think care for anxiety could be improved? Consumers reported generally positive views of their GP when seeking help for anxiety, though they had mixed experiences of the approach taken to treatment. Consumers noted that they prioritise effective treatment above other factors and are less concerned with how quickly their treatment works. A preference for psychological intervention or combined treatment with medication was apparent. Consumers noted that key areas for improving care for anxiety were improving access and funding for psychological treatments, increasing community knowledge about anxiety, and reducing stigma.
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Affiliation(s)
- Erin Parker
- Research School of Psychology, Australian National University, Canberra 2601, Australia
- Correspondence: (E.P.); (M.B.)
| | - Michelle Banfield
- Centre for Mental Health Research, Australian National University, Canberra 2601, Australia
- Correspondence: (E.P.); (M.B.)
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OUP accepted manuscript. Eur J Orthod 2022; 44:369-376. [DOI: 10.1093/ejo/cjac008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Semyonov-Tal K. The voice of patients in Israel's general hospitals. Int J Health Care Qual Assur 2021; ahead-of-print. [PMID: 33942593 DOI: 10.1108/ijhcqa-10-2020-0192] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this study is to capture the variety of issues that concern patients and to examine the extent to which personal characteristics of patients, such as education, ethnicity, age, gender and conditions of hospitalisation, influence the tendency to "express (negative) voice" and raise "critical views". DESIGN/METHODOLOGY/APPROACH Using data obtained from the 2014 Survey of Health Satisfaction in Israel, the study focuses on patients' responses to an open-ended question regarding the medical care experience in hospitals. FINDINGS The analysis reveals that "the voice of patients" spreads across a wide variety of issues, including the physical condition of the hospital and caregiver behaviour. Multivariate regression models show that subgroups with greater access to social and economic resources (i.e. in Israel, individuals who are Jewish), academics, women and younger patients are more likely to express critical voice regarding the hospitalisation experience. Likewise, inferior hospitalisation conditions are likely to increase expression of negative "voice" and criticism. ORIGINALITY/VALUE The findings underscore the importance and value of open-ended questions in evaluating healthcare satisfaction, suggesting that the likelihood of expressing critical voice is higher among patients of high socio-economic status - perhaps because they are more likely to expect, demand and feel entitled to high-quality care. Likewise, inferior hospitalisation conditions increase the critical voice.
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Djambazov SN, Giammanco MD, Gitto L. Factors That Predict Overall Patient Satisfaction With Oncology Hospital Care in Bulgaria. Value Health Reg Issues 2019; 19:26-33. [PMID: 30641294 DOI: 10.1016/j.vhri.2018.11.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Revised: 11/07/2018] [Accepted: 11/29/2018] [Indexed: 11/18/2022]
Abstract
BACKGROUND The relevance of studies focusing on patient satisfaction becomes imperative for patients with cancer, who often face major changes in their lifestyles. Their perceived uncertainty in illness and their personal experiences with the services received are crucial factors for a qualitatively adequate assistance. OBJECTIVES To assess the determinants of patient satisfaction, using a sample of 306 Bulgarian oncology outpatients. METHODS The hypotheses tested concern the extent to which patient satisfaction depends on the uncertainty in illness; the patients' assessment of technical and interpersonal skills of nurses and medical staff; the information provision; and some organizational aspects. Patients were asked to answer a questionnaire composed of internationally validated scales assessing the determinants of patient satisfaction (measured through the European Organization for Research and Treatment of Cancer), uncertainty in illness (assessed through the Mishel Uncertainty in Illness Scale), and patients' health status (assessed through the EuroQol 5-dimensional questionnaire and the visual analogue scale). An ordered logit model was run, using the level of overall patient satisfaction as a dependent variable. RESULTS This is one of the first studies carried out in Bulgaria for oncology patient satisfaction of subjective factors related to the frailty of the oncology patient status such as age, self-assessed health-related quality of life, and uncertainty in illness. Nevertheless, other determinants, reflecting the quality of the care provided, also have an impact on patient satisfaction, namely, the assessment of the nonmedical personnel, the perception of medical technical skills, and the access to a medical center. CONCLUSIONS Results stress the relevance of reducing uncertainty in illness in patients with cancer by implementing a satisfactory patient-physician relationship in the management of the disease.
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Affiliation(s)
| | | | - Lara Gitto
- CEIS Sanità EEHTA, University of Rome "Tor Vergata", Rome, Italy
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Trivedi R, Jagani K. Perceived service quality, repeat use of healthcare services and inpatient satisfaction in emerging economy. INTERNATIONAL JOURNAL OF PHARMACEUTICAL AND HEALTHCARE MARKETING 2018. [DOI: 10.1108/ijphm-11-2017-0065] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this study is to understand that how different demographic variables and repeated availing of service from the same doctor or same hospital shape the overall perception of health-care service quality and satisfaction among inpatients admitted in private hospitals in an emerging economy.
Design/methodology/approach
A self-administered, cross-sectional survey of inpatients using a questionnaire was translated into Hindi and Gujarati. The data were collected from 702 inpatients from 18 private clinics located in three selected cities from Western India.
Findings
The results indicate that experience with hospital administration, doctors, nursing staff, physical environment, hospital pharmacy and physical environment is significant predictor of inpatient satisfaction. Physical environment was found to be significantly associated with satisfaction only among female inpatient. It was also found that repeat availing of services either from the same hospital or doctor does not increase patient satisfaction. The feasibility, reliability and validity of the instrument that measures major technical and nontechnical dimensions of quality of health-care services were established in the context of a developing country.
Originality/value
The study makes important contribution by empirically investigating the inpatient assessment of health-care service quality based upon their demographic information and repeated availing of services to understand how repeat visit shapes the service quality perception.
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Rogo-Gupta LJ, Haunschild C, Altamirano J, Maldonado YA, Fassiotto M. Physician Gender Is Associated with Press Ganey Patient Satisfaction Scores in Outpatient Gynecology. Womens Health Issues 2018; 28:281-285. [PMID: 29429946 DOI: 10.1016/j.whi.2018.01.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Revised: 12/27/2017] [Accepted: 01/05/2018] [Indexed: 10/18/2022]
Abstract
BACKGROUND Patient satisfaction is gaining increasing attention as a quality measure in health care, but the methods used to assess it may negatively impact women physicians. OBJECTIVE Our objective was to examine the relationship between physician gender and patient satisfaction with outpatient gynecology care as measured by the Press Ganey patient satisfaction survey. STUDY DESIGN This cross-sectional study analyzed 909 Press Ganey patient satisfaction surveys linked to outpatient gynecology visits at a single academic institution (March 2013-August 2014), including self-reported demographics and satisfaction. Surveys are delivered in a standardized fashion electronically and by mail. Surveys were completed by 821 unique patients and 13,780 gynecology visits occurred during the study period. The primary outcome variable was likelihood to recommend (LTR) a physician. We used χ2 tests of independence to assess the effect of demographic concordance on LTR and two generalized estimating equations models were run clustered by physician, with topbox physician LTR as the outcome variable. Analysis was performed in SAS Enterprise Guide 7.1 (SAS, Inc., Cary, NC). RESULTS Nine hundred nine surveys with complete demographic data were completed by women during the study period (mean age, 49.3 years). Age- and race-concordant patient-physician pairs received significantly higher proportions of top LTR score than discordant pairs (p = .014 and p < .0001, respectively). In contrast, gender-concordant pairs received a significantly lower proportion of top scores than discordant pairs (p = .027). In the generalized estimating equations model adjusting for health care environment, only gender remained statistically significant. Women physicians had significantly lower odds (47%) of receiving a top score (odds ratio, 0.53; 95% CI, 0.37-0.78; p = .001). CONCLUSIONS Women gynecologists are 47% less likely to receive top patient satisfaction scores compared with their male counterparts owing to their gender alone, suggesting that gender bias may impact the results of patient satisfaction questionnaires. Therefore, the results of this and similar questionnaires should be interpreted with great caution until the impact on women physicians is better understood.
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Affiliation(s)
- Lisa J Rogo-Gupta
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California.
| | - Carolyn Haunschild
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, California
| | - Jonathan Altamirano
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California
| | - Yvonne A Maldonado
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California
| | - Magali Fassiotto
- Office of Faculty Development and Diversity, Stanford University School of Medicine, Stanford, California
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Johnson DM, Russell RS. SEM of Service Quality to Predict Overall Patient Satisfaction in Medical Clinics: A Case Study. ACTA ACUST UNITED AC 2017. [DOI: 10.1080/10686967.2015.11918448] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Chan AHY, Stewart AW, Harrison J, Black PN, Mitchell EA, Foster JM. Electronic adherence monitoring device performance and patient acceptability: a randomized control trial. Expert Rev Med Devices 2017; 14:401-411. [PMID: 28434269 DOI: 10.1080/17434440.2017.1322505] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND To investigate the performance and patient acceptability of an inhaler electronic monitoring device in a real-world childhood asthma population. METHODS Children 6 to 15 years presenting with asthma to the hospital emergency department and prescribed inhaled corticosteroids were included. Participants were randomized to receive a device with reminder features enabled or disabled for use with their preventer. Device quality control tests were conducted. Questionnaires on device acceptability, utility and ergonomics were completed at six months. RESULTS A total of 1306 quality control tests were conducted; 84% passed pre-issue and 87% return testing. The most common failure reason was actuation under-recording. Acceptability scores were high, with higher scores in the reminder than non-reminder group (median, 5th-95th percentile: 4.1, 3.1-5.0 versus 3.7, 2.3-4.8; p < 0.001). Most (>90%) rated the device easy to use. Feedback was positive across five themes: device acceptability, ringtone acceptability, suggestions for improvement, effect on medication use, and effect on asthma control. CONCLUSIONS This study investigates electronic monitoring device performance and acceptability in children using quantitative and qualitative measures. Results indicate satisfactory reliability, although failure rates of 13-16% indicate the importance of quality control. Favorable acceptability ratings support the use of these devices in children.
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Affiliation(s)
- Amy Hai Yan Chan
- a School of Pharmacy, Faculty of Medical and Health Sciences , The University of Auckland , Auckland , New Zealand.,b Department of Pediatrics: Child and Youth Health, Faculty of Medical and Health Sciences , The University of Auckland , Auckland , New Zealand
| | - Alistair William Stewart
- c Epidemiology & Biostatistics, School of Population Health, Faculty of Medical and Health Sciences , The University of Auckland , Auckland , New Zealand
| | - Jeff Harrison
- a School of Pharmacy, Faculty of Medical and Health Sciences , The University of Auckland , Auckland , New Zealand
| | - Peter Nigel Black
- d Department of Pharmacology, Faculty of Medical and Health Sciences , The University of Auckland , Auckland , New Zealand
| | - Edwin Arthur Mitchell
- b Department of Pediatrics: Child and Youth Health, Faculty of Medical and Health Sciences , The University of Auckland , Auckland , New Zealand
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The Impact of Race on Patient Satisfaction With Primary Care Physicians. Health Care Manag (Frederick) 2017; 36:29-38. [PMID: 27669426 DOI: 10.1097/hcm.0000000000000128] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Affiliation(s)
- Paul Grant
- Royal Sussex County Hospital; Brighton UK
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Abstract
The purpose of this study was to examine factors that impact consumer satisfaction with health care. This is a secondary analysis of the Center for Studying Health System Change's 2010 Health Tracking Household Survey. Regression analysis was used to examine the impact of treatment issues, financial issues, family-related issues, sources of health care information, location, and demographics-related factors on satisfaction with health care. The study involved 12280 subjects, 56% of whom were very satisfied with their health care, whereas 66% were very satisfied with their primary care physician. Fourteen percent of the subjects had no health insurance; 34% of the subjects got their health care information from the Web. Satisfaction with primary care physician, general health status, promptness of visit to doctor, insurance type, medical cost per family, annual income, persons in family, health care information from friends, and age significantly impacted satisfaction with health care. The regression models accounted for 23% of the variance in health care satisfaction. Satisfaction with primary care physicians, health insurance, and general health status are the 3 most significant indicators of an individual's satisfaction with health care.
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Alrashdi I. Evaluation of quality of healthcare: to what extent can we rely on patient expectations and preferences. Oman Med J 2012; 27:448-9. [PMID: 23226813 DOI: 10.5001/omj.2012.107] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2012] [Accepted: 10/06/2012] [Indexed: 11/03/2022] Open
Affiliation(s)
- Ismail Alrashdi
- Department of Quality Management, Royal Hospital, Sultanate of Oman
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Hazilah Abd Manaf N. Inpatient satisfaction: an analysis of Malaysian public hospitals. INTERNATIONAL JOURNAL OF PUBLIC SECTOR MANAGEMENT 2012; 25:6-16. [DOI: 10.1108/09513551211200258] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
Abstract
PurposeThe purpose of this paper is to provide an empirical analysis on inpatient satisfaction in Malaysian public hospitals.Design/methodology/approachA self‐administered questionnaire was the main data collection method. Altogether, 23 hospitals throughout Peninsular Malaysia participated in the survey. Cluster sampling was used in the selection of the respondent hospitals, while convenience sampling was used in administering the survey.FindingsThree factors of inpatient satisfaction were extracted, which were clinical and physical dimensions of service, and additional facilities for patients and family members. Inpatient satisfaction was found to be higher for the clinical dimension than for the physical dimension. Overall, inpatient satisfaction was high, as reflected by the high mean score of the variables, although caution was expressed in interpreting the findings, particularly the low expectations of patients to begin with.Research limitations/implicationsThe research was limited to inpatients of Malaysian public hospitals. A thorough evaluation of the nation's public healthcare delivery system would need to include outpatient services as well.Originality/valueThe paper provides an empirical analysis on inpatient satisfaction in Malaysian public hospitals. This allows policy makers to evaluate the level of public healthcare delivery service in the country and therefore assist in policy decision‐making and implementation.
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Omondi NA, Denzen EM, Jacobson DJ, Payton TJ, Pederson K, Murphy EA. Evaluating patient satisfaction with the Office of Patient Advocacy. JOURNAL OF CANCER EDUCATION : THE OFFICIAL JOURNAL OF THE AMERICAN ASSOCIATION FOR CANCER EDUCATION 2011; 26:44-50. [PMID: 20811819 DOI: 10.1007/s13187-010-0153-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Patient satisfaction is an important indicator of healthcare quality. Blood and marrow transplantation is a complex but potentially curative procedure for patients with life-threatening hematologic disorders. The Office of Patient Advocacy provides services and health education materials to transplant patients, caregivers, and family members. Satisfaction surveys help identify the specific needs of patients. This article reports findings from surveys administered to patients and family members. Key evaluation areas included: helpfulness of information and services provided and overall satisfaction with Coordinator services. Respondents were asked to describe follow-up actions taken as a result of the information/services provided and to recommend ways to improve these services. Transplant patients face complex treatment with high risks of morbidity, which may impact likelihood of survey response. The findings indicate that satisfied respondents were more likely to self advocate through follow-up actions. Respondent feedback was useful for improving Office of Patient Advocacy services.
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Affiliation(s)
- Nancy A Omondi
- Office of Patient Advocacy, Patient Services, National Marrow Donor Program, 3001 Broadway St NE, Suite 100, Minneapolis, MN 55413, USA.
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Badri MA, Attia S, Ustadi AM. Healthcare quality and moderators of patient satisfaction: testing for causality. Int J Health Care Qual Assur 2010; 22:382-410. [PMID: 19725210 DOI: 10.1108/09526860910964843] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this article is to present a comprehensive structural equation based service quality and patient satisfaction model taking into account the patient's condition before and after discharge. The authors aim to test for causality in a sample of patients from United Arab Emirates public hospitals. DESIGN/METHODOLOGY/APPROACH Data were collected using questionnaires completed by adults discharged (n = 244) from UAE public hospitals. The proposed model consists of five main constructs. Three represent service quality: quality of care (four variables); process and administration (four variables) and information (four variables). There is also one construct that represents patient's status (two variables--health status before admission and after discharge). Finally, there is one construct that represents patient's satisfaction with care (two variables--general and relative satisfaction). Structural equation modeling and LISREL using maximum likelihood estimation was used to test hypothesized model(s)/parameters(s) derived deductively from the literature. FINDINGS The structural equation modeling representation provides a comprehensive picture that allows healthcare constructs and patient satisfaction causality to be tested. The goodness-of-fit statistics supported the healthcare quality-patient status-satisfaction model. ORIGINALITY/VALUE The model has been found to capture attributes that characterize healthcare quality in a developing country and could represent other modern healthcare systems. Also, it can be used to evaluate other healthcare practices from patients' viewpoints. The study highlights the importance of healthcare quality as patient satisfaction predictors by capturing other effects such as patient status.
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Affiliation(s)
- Masood A Badri
- United Arab Emirates University, College of Business Administration, Al Ain, United Arab Emirates.
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Seip B, Bretthauer M, Dahler S, Friestad J, Huppertz-Hauss G, Høie O, Kittang E, Nyhus S, Pallenschat J, Sandvei P, Stallemo A, Svendsen MV, Hoff G. Sustaining the vitality of colonoscopy quality improvement programmes over time. Experience from the Norwegian Gastronet programme. Scand J Gastroenterol 2010; 45:362-9. [PMID: 20095874 DOI: 10.3109/00365520903497106] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE An important challenge of any quality assurance (QA) programme is to maintain interest among participants to ensure high data quality over time. The primary aim of this study was to identify factors associated with endoscopist compliance with the Norwegian QA programme for colonoscopies (Gastronet). MATERIAL AND METHODS The Gastronet registration tools are an endoscopy report form to be filled in directly after the procedure by the endoscopist, and a satisfaction questionnaire to be filled in by the patient on the day after the examination. During the study period from 1 January 2004 to 31 December 2006, endoscopist compliance was measured by assessing patient report coverage, defined as the percentage of patient satisfaction questionnaires received by the Gastronet secretariat divided by the total number of colonoscopy reports registered by the individual endoscopists during the study period. Multivariate logistic regression models were applied to identify individual factors related to patient report coverage. RESULTS Eighty-eight endoscopists from 10 hospitals contributed a total of 16,149 colonoscopies. Overall patient report coverage decreased from 87% in 2004 to 80% in 2006. A low patient report coverage was associated with time since the registrations started [odds ratio (OR) 0.98, 95% confidence interval (CI) 0.97-0.98; P < 0.001], use of sedation (OR 0.7, 95% CI 0.61-0.76; P < 0.001), and incomplete colonoscopy (OR 0.6, 95% CI 0.54-0.76; P < 0.001). CONCLUSIONS Decreasing compliance with registration over time may compromise data quality and the validity of the results. Lower coverage of patient's reports (presumably for the most difficult examinations) may lead to erroneous conclusions regarding colonoscopy performance.
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Affiliation(s)
- Birgitte Seip
- Department of Medicine, Telemark Hospital, Skien, Norway.
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Papanikolaou V, Ntani S. Addressing the paradoxes of satisfaction with hospital care. Int J Health Care Qual Assur 2009; 21:548-61. [PMID: 19055265 DOI: 10.1108/09526860810900709] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
PURPOSE The purpose of this paper is to assess patient satisfaction in Greek public hospitals. DESIGN/METHODOLOGY/APPROACH In total, 367 patients participated in the study with a minimum of three days stay at the hospital. Measures included overall satisfaction, satisfaction with medical and nursing staff, satisfaction with room facilities, waiting times, extra costs. Information was also collected concerning sex, age, education, salary and length of stay in the hospital. Participants were also asked to indicate, in an open-ended question, the most positive and the most negative aspects of their care. FINDINGS Patients' bad experience with aspects of their care was not directly reflected in low levels of satisfaction. Patients had to wait long hours to get an appointment with a doctor or after their examination to be admitted to the hospital. Many patients had to rely on a personal nurse and to pay extra money to the medical and nursing staff. They considered lack of staff as the main drawback of the hospital. However, their overall satisfaction was very high. RESEARCH LIMITATIONS/IMPLICATIONS These results raise concerns about how patients evaluate. Patients are expected to act as consumers who carefully evaluate the aspects of care they receive. However, the aspects of care which patients take for granted when they evaluate their experience with health care providers needs to be illustrated further. Patients' relationship with health care providers may reflect trust rather than rational choice. ORIGINALITY/VALUE This paper provides useful information on assessing patient satisfaction in Greek public hospitals which could be used elsewhere.
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Affiliation(s)
- Vicky Papanikolaou
- Department of Health Service Management, National School of Public Health, Athens, Greece.
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Badri MA, Attia ST, Ustadi AM. Testing not-so-obvious models of healthcare quality. Int J Health Care Qual Assur 2008; 21:159-74. [PMID: 18578201 DOI: 10.1108/09526860810859021] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to show that, although there has been some research to identify the dimensions on which healthcare quality and in-patient satisfaction should be measured, the confirmation of constructs and indicators that constitute an overall care quality and satisfaction remains unclear. The objective is to present several models of service quality and satisfaction in healthcare for discharged patients; and to test those models in a sample of discharged patients in public hospitals in the United Arab Emirates. DESIGN/METHODOLOGY/APPROACH A detailed in-patient survey (using interviews) was used. Data were collected with questionnaires from adult discharges (n = 244) in public hospitals in the UAE. Several structures are proposed and tested. Confirmatory Factor Analysis (CFA) and LISREL SIMPLIS using maximum likelihood estimation were used to estimate and test the parameters of the hypothesized models derived deductively from the previous literature. FINDINGS Several models (with one, two, three and four constructs) with different structures were tested using CFA. The final recommended model is based on three constructs--quality of care, process and administration, and information. The goodness-of-fit statistics supported the basic solution of the healthcare quality-satisfaction model. ORIGINALITY/VALUE The model has been found to capture attributes that characterize healthcare quality in a developing country such as the UAE and could represent other modern healthcare systems. It can be used as a basis for evaluation in healthcare practices from discharges (in-patients) point of view. The study highlights the importance of patients' satisfaction with care as predictors of quality of care. The results also confirm the construct validity of the previously discussed healthcare quality scales.
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Affiliation(s)
- Masood A Badri
- College of Business Administration, United Arab Emirates University, Al Ain, United Arab Emirates.
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Bakar C, Seval Akgün H, Al Assaf A. The role of expectations in patient assessments of hospital care. Int J Health Care Qual Assur 2008; 21:343-55. [DOI: 10.1108/09526860810880144] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
PURPOSE Understanding patients' experiences of their interactions with health services is an important step in building quality from within. The purpose of this article is to look at the possibilities for involving service users in the development of the National Health Service in England through the structure of integrated care pathways (ICPs). DESIGN/METHODOLOGY/APPROACH A systematic literature review was undertaken to identify how patient experiences have been attained and used in three clinical areas: cataract care, hip replacement and knee arthroscopy. The information was weighted according to methodological criteria and synthesized according to the typical stages of each pathway. Key issues were summarised thematically across each pathway. FINDINGS The findings relate to the use of patient views and experiences within organisational structures, service development, methodological research, education and training. The article identifies important issues of practical significance for involving service users in the planning and development of patient focused ICPs: such as the diversity of patients, perspectives of continuity, information and patient support and the need for methodological research. RESEARCH LIMITATIONS/IMPLICATIONS The review is limited in that the literature across all three pathways tends to report findings of small studies undertaken in one clinical service or setting and most studies are not randomised or controlled. ORIGINALITY/VALUE The literature identified by the review contains important messages for both NHS policy and future research to involve service users in the planned expansion and plurality of NHS care.
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Hazilah Abd Manaf N, Siew Nooi P. Patient Satisfaction as An Indicator of Service Quality In Malaysian Public Hospitals. ACTA ACUST UNITED AC 2007. [DOI: 10.1108/15982688200700028] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Mah JK, Tough S, Fung T, Douglas-England K, Verhoef M. Parents’ Global Rating of Mental Health Correlates with SF-36 Scores and Health Services Satisfaction. Qual Life Res 2006; 15:1395-401. [PMID: 16960752 DOI: 10.1007/s11136-006-0014-z] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2006] [Indexed: 01/18/2023]
Abstract
BACKGROUND Patient satisfaction surveys are often used to measure quality of care. However, patient satisfaction may not be a reliable indicator of service quality because satisfaction can be influenced by clients' characteristics such as their health status. METHODS Parents of children attending a pediatric neurology clinic completed the Short Form Health Survey (SF-36) and global ratings of their physical and mental health. They also completed the Client Satisfaction Questionnaire (CSQ), the Measure of Processes of Care (MPOC), and the Family-Centered Care Survey (FCCS). RESULTS 104 parents completed the survey. The correlation between the global rating of physical or mental health and their corresponding SF-36 scores was high. The majority (88%) of parents were satisfied, with a median CSQ score of 28 (IQR, 24 to 31) and a FCCS score of 4.7 (IQR, 4.2 to 4.9). Logistic regression identified parents' mental health as a significant predictor of client satisfaction (OR, 1.07; 95% CI, 1.01 to 1.14). CONCLUSIONS Given the positive association between parents' mental health and satisfaction with care, it is important to consider mental status as a covariate in interpreting satisfaction surveys. Parents' global rating of mental health appears to be a reasonable indicator of their SF-36 mental scores.
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Affiliation(s)
- Jean K Mah
- Division of Neurology, Department of Pediatrics, Faculty of Medicine, Alberta Children's Hospital, University of Calgary, Alberta, Canada T2T 5C7.
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Abstract
Research on patient satisfaction has focused predominantly on the mainstream adult population (ages 18-64). Satisfaction in older patients has not been adequately studied. Moreover, a systematic review of the research literature that does exist on this topic has not yet been conducted. The literature search yielded only 17 studies that met the selection criteria established for this review. Key research elements and findings from each of the studies are arrayed in matrix form. The results of the literature review are organized and analyzed in terms of four major categories of variables: background characteristics, predispositional variables, service quality attributes, and contextual factors. Special attention is awarded to identifying the determinants of satisfaction among elderly patients and the ways in which their service quality appraisals may differ in comparison with the general adult population of medical care consumers. Implications for management practice and directions for future research are discussed.
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Affiliation(s)
- Dennis J Scotti
- Center for Health Care Management Studies, Fairleigh Dickinson University, Teaneck, NJ, USA.
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Clark PA, Kaldenberg DO, Drain M, Wolosin RJ. Elderly inpatients' priorities for acute care service quality. Int J Health Care Qual Assur 2004; 17:92-104. [PMID: 15301266 DOI: 10.1108/09526860410526718] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study examines elderly and advanced elderly inpatients' perceptions of acute care service quality, prioritises opportunities for quality improvement, and assesses variation in patients' satisfaction with care. Psychometrically-validated postal questionnaires were sent to random samplings of patients discharged from the US acute care facilities in 2002 (n = 2,057,164). Quality improvement priorities among non-elderly (< 65 years), elderly (65-74 years), and advanced elderly (> 74 years) were similar but substantial variation was found comparing single items between age groups. Elderly and advanced elderly patients rated the quality of meals and rooms significantly lower than the non-elderly, and the advanced elderly rated treatment decision making involvement significantly lower than the other two age groups. The data reveals specific, actionable areas for quality improvement and a non-linear relationship between age and satisfaction. Findings question assumptions regarding older patients' evaluations of care and indicate directions for quality improvement that account for their unique needs.
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Affiliation(s)
- Paul Alexander Clark
- Department of Research, Operations and Service, Press Ganey Associates, South Bend, Indiana, USA
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28
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Atkinson MJ, Sinha A, Hass SL, Colman SS, Kumar RN, Brod M, Rowland CR. Validation of a general measure of treatment satisfaction, the Treatment Satisfaction Questionnaire for Medication (TSQM), using a national panel study of chronic disease. Health Qual Life Outcomes 2004; 2:12. [PMID: 14987333 PMCID: PMC398419 DOI: 10.1186/1477-7525-2-12] [Citation(s) in RCA: 652] [Impact Index Per Article: 32.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2004] [Accepted: 02/26/2004] [Indexed: 11/21/2022] Open
Abstract
Background The objective of this study was to develop and psychometrically evaluate a general measure of patients' satisfaction with medication, the Treatment Satisfaction Questionnaire for Medication (TSQM). Methods The content and format of 55 initial questions were based on a formal conceptual framework, an extensive literature review, and the input from three patient focus groups. Patient interviews were used to select the most relevant questions for further evaluation (n = 31). The psychometric performance of items and resulting TSQM scales were examined using eight diverse patient groups (arthritis, asthma, major depression, type I diabetes, high cholesterol, hypertension, migraine, and psoriasis) recruited from a national longitudinal panel study of chronic illness (n = 567). Participants were then randomized to complete the test items using one of two alternate scaling methods (Visual Analogue vs. Likert-type). Results A factor analysis (principal component extraction with varimax rotation) of specific items revealed three factors (Eigenvalues > 1.7) explaining 75.6% of the total variance; namely Side effects (4 items, 28.4%, Cronbach's Alpha = .87), Effectiveness (3 items, 24.1%, Cronbach's Alpha = .85), and Convenience (3 items, 23.1%, Cronbach's Alpha = .87). A second factor analysis of more generally worded items yielded a Global Satisfaction scale (3 items, Eigenvalue = 2.3, 79.1%, Cronbach's Alpha = .85). The final four scales possessed good psychometric properties, with the Likert-type scaling method performing better than the VAS approach. Significant differences were found on the TSQM by the route of medication administration (oral, injectable, topical, inhalable), level of illness severity, and length of time on medication. Regression analyses using the TSQM scales accounted for 40–60% of variation in patients' ratings of their likelihood to persist with their current medication. Conclusion The TSQM is a psychometrically sound and valid measure of the major dimensions of patients' satisfaction with medication. Preliminary evidence suggests that the TSQM may also be a good predictor of patients' medication adherence across different types of medication and patient populations.
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Affiliation(s)
- Mark J Atkinson
- Worldwide Outcomes Research, La Jolla Laboratories, Pfizer Inc., 10777 Science Center Drive (B-95), San Diego, CA 92121-1111, USA
| | - Anusha Sinha
- Quintiles Strategic Research Services, Quintiles Inc., San Francisco, CA, USA
| | | | - Shoshana S Colman
- Quintiles Strategic Research Services, Quintiles Inc., San Francisco, CA, USA
| | - Ritesh N Kumar
- University of Michigan, College of Pharmacy, Ann Arbor, MI, USA
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Labarère J, Fourny M, Jean-Phillippe V, Marin-Pache S, Patrice F. Refinement and validation of a French in‐patient experience questionnaire. Int J Health Care Qual Assur 2004; 17:17-25. [PMID: 15046467 DOI: 10.1108/09526860410515909] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to check psychometric properties of a French-language in-patient experience questionnaire in a test sample different from the development sample. The questionnaire was sent out to 5,736 in-patients, within two to four weeks of discharge from a teaching hospital of 2,200 beds. Overall 4,095 questionnaires (71.4 per cent) were returned. Of these, 3,879 questionnaires were analyzed. In principal component analysis, seven principal components accounted for 62.4 per cent of the total variance. Cronbach's alpha coefficient ranged from 0.62 to 0.90, with the exception of the seventh scale (convenience scale, two items, Cronbach = 0.39). The overall patient experience score increased with increasing patient age (except for patients older than 65), male sex, low education level, use of a single room, and prior stay in the department. It also differed with respect to patients' behavioral intentions, answers to an overall satisfaction item, and open-ended comments.
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Affiliation(s)
- José Labarère
- Unité de Qualitique et d'Evaluation Médicale, CHU, Grenoble, France
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30
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Hwang LJJ, Eves A, Desombre T. Gap analysis of patient meal service perceptions. INTERNATIONAL JOURNAL OF HEALTH CARE QUALITY ASSURANCE INCORPORATING LEADERSHIP IN HEALTH SERVICES 2003; 16:143-53. [PMID: 12870254 DOI: 10.1108/09526860310470874] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The provision of food and drinks to patients remains a largely unexplored, multidimensional phenomenon. In an attempt to ameliorate this lack of understanding, a survey utilising a modified SERVQUAL instrument measured on a seven-point Likert scale was carried out on-site at four NHS acute trusts for the purpose of assessing the perceptions and expectations of meal attributes and their importance in determining patient satisfaction. The results of factor analysis found three dimensions: food properties, interpersonal service, and environmental presentation, with a high reliability (Cronbach's alpha from 0.9191 to 0.7836). Path analysis further established sophisticated causal relations with patient satisfaction. The food dimension was found to be the best predictor of patient satisfaction among the three dimensions, while the interpersonal service dimension was not found to have any correlation with satisfaction. Bridging the gaps that exist between perceptions and expectations can improve the quality of meal services for the purpose of maximising patient satisfaction and ultimately aiding in patient recovery.
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Abstract
Within the health care community, more and more emphasis is being placed on patient satisfaction. This study was undertaken in a midwestern, nonprofit, 300-bed acute care hospital to gain a better understanding of how nonresponse rates and patient characteristics affect patient satisfaction scores. With a response rate of 34.2%, it appears that nonresponse bias may have an impact. When looking at variables that may affect the overall score, the multiple regression model used in this analysis was able to explain only 7.5% of the variability in the overall satisfaction score seeming to indicate the unpredictability of the score. This study supports the need to analyze groups of patients rather than patients as a whole to determine what affects their response, both within and between healthcare organizations.
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Affiliation(s)
- Susan H Spooner
- Department of Information Technology, Iowa Health System, Sioux City 51104, USA.
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Lee‐Ross D. Development of the service predisposition instrument. JOURNAL OF MANAGERIAL PSYCHOLOGY 2000. [DOI: 10.1108/02683940010310337] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Tengilimoglu D, Kisa A, Dziegielewski SF. Consumer opinions with ancillary hospital services: improving service delivery in Turkish hospitals. J Med Syst 1999; 23:363-75. [PMID: 10587917 DOI: 10.1023/a:1020529217414] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This article reports the results of 2,045 consumer interviews conducted after discharge from seven major public and private hospitals in the country of Turkey. The direct measurement of consumer-satisfaction and utilization of this information to improve service delivery is a relatively new phenomena for this country. Based on postdischarge consumer interviews information on satisfaction of several ancillary hospital service variables was identified and inclusion for achieving overall consumer satisfaction is emphasized. Two critical areas were examined: ancillary staff and consumer relations and overall impressions of the comfort of the facility. Relationships and percentages within and among these variables are reported. Overall, the majority of the complaints noted by consumers were not related to direct treatment rather they focused on interactions with the hospital's staff and other services provided by the facility (e.g., comfort, cleanliness, parking, etc.). When comparing the different hospitals across these variables significant differences were noted at the .05 level between the seven different hospitals examined. Findings and recommendations from this study are presented to assist in providing a basis for the development of improved consumer satisfaction.
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Affiliation(s)
- D Tengilimoglu
- School of Allied Health, Gazi University, Teknikokullar, Ankara, Turkey
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Affiliation(s)
- Sue Proctor
- Health Services Research, Department of General Practice, Kings College London
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35
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Lee‐Ross D. A comparison of service predispositions between NHS nurses and hospitality workers. Int J Health Care Qual Assur 1999. [DOI: 10.1108/09526869910265084] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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36
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Tengilimoglu D, Kisa A, Dziegielewski SF. Patient satisfaction in Turkey: differences between public and private hospitals. J Community Health 1999; 24:73-91. [PMID: 10036649 DOI: 10.1023/a:1018769316379] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
This article reports the results of a patient-satisfaction survey administered by interview to 2045 adults discharged from several major public and private hospitals in Turkey. The direct measurement of patient-satisfaction is a new phenomenon for this country. An instrument was designed similar to those available in the United States and administered during exit interviews. Two primary areas of analyses were determined in comparing services provided by these public and private hospitals: demographic factors with regard to accessibility and consumer perceptions of the quality of service provided. Relationships and percentages within and among the five public and two private hospitals are reported. Several statistically significant differences were found between the hospitals, with the private hospitals achieving the greatest satisfaction on most of the quality of services issues examined. Future recommendations outline the need to take into account the public's perception of these hospitals and enhancing customer satisfaction as a means of increasing service utilization.
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Affiliation(s)
- D Tengilimoglu
- School of Allied Health, Gazi University Teknikokullar, Ankara-Turkey
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