An exploration of patient-reported experiences of aspects of integrated care in New South Wales

Abstract

Introduction: Increase in complex chronic diseases, development of systematic pathways of care and specialisation of healthcare providers poses challenges to ensure coordinated and continuous care for patients. Integration of care is an objective for various healthcare systems. The aim of this study is to assess the variation in patient-reported experiences of aspects of healthcare integration in New South Wales (NSW) public hospitals. Methods: The results were drawn from 17,746 respondents to the NSW Adult Admitted Patient Survey (AAPS) [January to June 2013] and 13,230 respondents to the NSW Emergency Department Survey (EDS) [April to September 2013]. Respondents had been patients of a medium or large public hospital in the given timeframe. Analysis was carried out on a selection of approximately 25 questions from each survey that addressed relevant themes such as integration of patients into care, integration of care between healthcare professionals, integration of care within hospitals and integration of care upon arrival and discharge. Results were weighted to the hospital population of age group and stay-type. Results: Whilst all measures showed variation between hospitals, some measures had a wider range of results, such as admitted patients’ reporting that they were ‘definitely’ involved in decisions about their care and treatment [mean: 59.4%, range: 46.2% 79.9%] and Emergency Department patients’ not receiving contradictory information from Emergency Department health professionals [mean: 72.8%, range: 44.6% 86.1%]. In NSW overall, there was also variation in results related to the different themes of integrated care. Some were rated more positively (such as information-provision and communication with patients), whilst others tended to show less positive ratings, including those around involvement of the patient in the ‘treatment team’ and to some extent, the integration of care between healthcare professionals. The individual measures that were rated most positively in NSW were provision of the ‘right amount’ of information to admitted patients about the medication they were taking home [91.5% of respondents] and World Congress on Integrated Care 2014, Sydney, November 23-26, 2014. International Journal of Integrated Care – Volume 14, 8 December – URN:NBN:NL:UI:10-1-116660– http://www.ijic.org/ Emergency Department health professionals providing the ‘right amount’ of information to a patient about their condition or treatment [85.6% of respondents]. Conclusion: Patient-reported experiences of care within and across different stages of the patient pathway can provide a complementary tool in evaluating the delivery of integrated care. These findings point to issues that could be targeted to improve the delivery of integrated care within the NSW public hospital sector. Limitations: The surveys used for this study were not developed specifically with integrated care in mind. While certain questions were included with the aim of measuring integrated care, the surveys may not include all relevant measures. Suggestions for Future Research: Further assessment on how to best balance the number of patient-reported measures by aspects of integrated care remains to be done.