Gibt es einen Zusammenhang zwischen den Auditergebnissen und den Patientinnenerfahrungen in Brustzentren in Nordrhein-Westfalen?

Abstract

To ensure and improve the quality of care, patients with breast cancer in North Rhine-Westphalia are supposed to be treated in certified breast centres only. To obtain this certification, every 3 years all centres must undergo an auditing process. They also have to participate in an annual patient survey. While some studies have evaluated the benefit of certified centres regarding the quality of care offered, here we evaluate the relationship between the audit results and the experiences of patients. The quantitative results of the audit reports of 2014-2016 of breast centres in North Rhine-Westphalia were linked by multilevel analyses with different scales of the annual, post-operative, postal survey of primary breast cancer patients. Audit reports and survey data on 3016 patients from 33 breast centres were examined and after adjusting for multiple testing, no statistically significant interrelation was found. There are no associations between the results of a centre in the audit and the experiences of the patients. It appears that patients have a distinctive, subjective perception that cannot be represented by the audits alone, even though patient orientation is explicitly requested in the certification catalogue. This result underlines the benefit of the obligatory annual patient survey because it can provide information that apparently cannot be obtained from other sources, such as certification audits. As a whole, an association between the audit results of a centre and the experiences of the patients treated there are weak. The audit results do correlate with the perceived process organization. However, other dimensions of patient experience are distinctive and subjective. Even though patient orientation is explicitly requested in the certification requirements, patient experience is not be represented by the audits alone. This finding underlines the benefit of obligatory annual patient surveys because they can provide additional information.