Dimensions Of Patient Experience Research Articles

Value-based care models for chronic hepatitis B and C among vulnerable populations: a scoping review

Abstract Background Chronic viral hepatitis B and C are a significant public health burden worldwide. The prevalence of these infections is much higher among migrants than in the general population, due to factors such as inadequate access to healthcare. The EU VH-COMSAVAC project aims to implement community-based HBV/HCV models of care among migrant populations with documented high HBV/HCV incidence and prevalence, using person-centred referral processes. Our study aims to provide an overview of the scientific evidence on value-based models of care for prevention, treatment and linkage-to-care in high-risk groups. Methods This scoping review was performed in the context of the EU VH-COMSAVAC project, following the PRISMA-ScR Checklist, by searching on 5 databases: Medline, EMBASE, GlobalHealth, Scopus and Web of Science. Articles published up to December 2020 investigating models of care targeting migrant populations and related to HBV/HCV prevention, treatment and linkage-to-care, were included. Results Out of a total of 2,767 articles screened, 83 were included and preliminarly categorized according to stages of care (prevention, treatment and linkage-to-care) and Bodenheimer’ pillars. Further investigation will be conducted concerning the dimensions of patient experience; utilized resources; population health; care-team well-being. Conclusions Implementing patient-centered care models for critical public health issues among specific populations is becoming incresingly relevant. This study will provide the conceptual basis for building a value-based assessment tool capable of evaluating new models of care for prevention, treatment and linkage-to-care for hepatitis B/ C in high-risk groups. Key messages • In order to reach viral hepatitis elimination targets, initiatives must pay particular attention to high-risk groups. • The value (population health, patient experience, care-team wellbeing and costs) of such care strategies should be assessed to contribute to their continuity.

Enriching healthcare service quality by leveraging service experiences in Indian private hospitals: application of fuzzy-AHP approach

PurposeOver the years, despite the best efforts to evaluate service quality through multiple techniques, the connotation between service deliverance and consumer expectation remains sporadic. In the quest to quantify service quality from an innovative perspective, the current study has leveraged consumer-perceived experiences to unveil the novel intricacies of healthcare quality.Design/methodology/approachAnchoring on the dimensions of patient experience (PX), field data were collected from 244 patients at different private hospitals operating across India. Further, this study incorporated a fuzzy analytic hierarchy process (F-AHP) to evaluate consumer preferences and prioritised the dimensions of PX in three categories of Indian hospitals, namely nursing homes (NHs), mid-tier corporate hospitals (MCHs) and top-tier corporate hospitals (TCHs).FindingsThe results establish a performance ranking by demonstrating that MCHs outperform the rest alternatives on the grounds of perceived experiences. Tukey's honestly significance difference (HSD) test was executed to confirm the heterogeneity among the participants' preferences across three different hospital categories. The results reveal that for most of the alternatives, the mean scores of the criterion were statistically significantly different.Originality/valueIn healthcare studies, PX dawned as an entity with an ability to propel healthcare quality in a better way than the classical techniques did. The study's findings present a comprehensive picture of a care delivery system by identifying relatively significant dimensions of PX, hence improving the quality quotients by adjusting healthcare offerings in alignment with consumer expectations and organisational strategies.

Walking in their shoes: How primary-care experiences of adults aged 50+ reveal the benefits of e-learning intervention for general practitioners.

Patient experiences and activation are increasingly researched. However, related data are limited in three areas: interventions for general practitioners (GPs) working with mature adults (50+), dedicated e-learning interventions for GPs, and assessments of e-learning for medical staff through patient experiences. We examined how e-learning intervention focused on improving GPs' skills in activating communication (understood as promoting engagement and active participation in healthcare) can enhance the experiences of mature patients. The intervention was designed for GPs, yet innovative assessment was based on patient experiences post-visit. Three research conditions for GPs (n = 165) were introduced: (1) e-learning or (2) pdf-article intervention and (3) control. Two independent waves of their patients participated before and after the intervention. Experience measures for patients (n = 1639) included the Patient Expectations Scale (post-visit), perceived GP's Communication Skills scale, and Patient Satisfaction with Visit scale. E-learning intervention compared with the control group had a favorable effect for 5 out of 8 dimensions of patient experience. Change in emotional support and quality of life was particularly visible. Mature patient experiences can be improved with the e-learning intervention for GPs. Measuring patient experience enriches the available knowledge and can help design future research and interventions.

Sociodemographic inequalities in patients' experiences of primary care: an analysis of the General Practice Patient Survey in England between 2011 and 2017.

ObjectiveYounger people, minority ethnic groups, sexual minorities and people of lower socioeconomic status report poorer experiences of primary care. In light of NHS ambitions to reduce unwarranted variations in care, we aimed to investigate whether inequalities in patient experience of primary care changed between 2011 and 2017, using data from the General Practice Patient Survey in England.MethodsWe considered inequalities in relation to age, sex, deprivation, ethnicity, sexual orientation and geographical region across five dimensions of patient experience: overall experience, doctor communication, nurse communication, access and continuity of care. We used linear regression to explore whether the magnitude of inequalities changed between 2011 and 2017, using mixed models to assess changes within practices and models without accounting for practice to assess national trends.ResultsWe included 5,241,408 responses over 11 survey waves from 2011–2017. There was evidence that inequalities changed over time (p < 0.05 for 27/30 models), but the direction and magnitude of changes varied. Changes in gaps in experience ranged from a 1.6 percentage point increase for experience of access among sexual minorities, to a 5.6 percentage point decrease for continuity, where experience worsened for older ages. Inequalities in access in relation to socio-economic status remained reasonably stable for individuals attending the same GP practice; nationally inequalities in access increased 2.1 percentage points (p < 0.0001) between respondents living in more/less deprived areas, suggesting access is declining fastest in practices in more deprived areas.ConclusionsThere have been few substantial changes in inequalities in patient experience of primary care between 2011 and 2017.

Do dual eligible beneficiaries experience better health care in special needs plans?

Dual Eligible Special Needs Plans (D-SNPs) were intended to provide better care for beneficiaries eligible for both Medicare and Medicaid through better coordination of these two programs. 671913 dual eligible (DE) respondents to the 2009-2019 Medicare Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. We compared the 2015-2019 experiences of DE beneficiaries in D-SNPs relative to fee-for-service Medicare (FFS) and non-SNP Medicare Advantage (MA) using propensity-score weighted linear regression. Comparisons were made to 2009-2014. 12 patient experience measures were considered. Annual mail survey with telephone follow-up of non-respondents. More than 65% of DE beneficiaries enrolled in FFS. Of 12 measures, D-SNP performance was higher than non-SNP MA on two (P<.05), lower than non-SNP MA on two (P<.05), and higher than FFS on four (P<.01). DE beneficiaries did not report better coordination of care in D-SNPs. D-SNP performance was often worse than other coverage types in prior periods. Relative to FFS Medicare, DE beneficiaries report higher immunization rates in D-SNPs, but slight or no better performance on other dimensions of patient experience. New requirements in 2021 may help D-SNPs attain their goal of better care coordination.

Exploring the dimensions of patient experience for community-based care programmes in a multi-ethnic Asian context.

IntroductionThe aim of this study is to explore patients’ experiences with community-based care programmes (CCPs) and develop dimensions of patient experience salient to community-based care in Singapore. Most countries like Singapore are transforming its healthcare system from a hospital-centric model to a person-centered community-based care model to better manage the increasing chronic disease burden resulting from an ageing population. It is thus critical to understand the impact of hospital to community transitions from the patients’ perspective. The exploration of patient experience will guide the development of an instrument for the evaluation of CCPs for quality improvement purposes.MethodsA qualitative exploratory study was conducted where face-to-face in-depth interviews were conducted using a purposive sampling method with patients enrolled in CCPs. In total, 64 participants aged between 41 to 94 years were recruited. A deductive framework was developed using the Picker Patient Experience instrument to guide our analysis. Inductive coding was also conducted which resulted in emergence of new themes.ResultsOur findings highlighted eight key themes of patient experience: i) ensuring care continuity, ii) involvement of family, iii) access to emotional support, vi) ensuring physical comfort, v) coordination of services between providers, vi) providing patient education, vii) importance of respect for patients, and viii) healthcare financing.ConclusionOur results demonstrated that patient experience is multi-faceted, and dimensions of patient experience vary according to healthcare settings. As most patient experience frameworks were developed based on a single care setting in western populations, our findings can inform the development of a culturally relevant instrument to measure patient experience of community-based care for a multi-ethnic Asian context.

The patient experience in inpatient unit between the patient in Makassar District Hospital and Haji Regional Hospital

This study aimed to compare the patient experiences of the inpatient unit at Makassar District Hospital and Haji Regional Hospital. This research was a cross-sectional study with a descriptive approach. The study involved 118 respondents in Makassar General Hospital and 120 respondents in Haji Regional Hospital. The results showed patients in Makassar district hospital had good experiences in 6 dimensions (information and communication, convenient environmental, medicine management, employee availability, respecting patient's experience, and service assistance). Patients in Haji regional hospital experienced good service in 6 dimensions of patient experience (waiting time, emotional support, pain management, trust inservice providers, perceived nutrition care, and family and friend involvement). Both of the hospitals have the same number of good experience dimensions. The study recommended the hospital to make improvements in terms of the quality of service by paying attention to other dimensions.

Psychometric Validation of a Nonproprietary Survey of Patient Satisfaction for Use in Outpatient Radiology Centers.

Demonstrate the psychometric evaluation process for and results from our radiology-specific patient experience measure. We developed a survey to measure five dimensions of patient experience: (1) appointment, (2) reception, (3) registration, (4) procedure, and (5) facility. Each dimension included three to five questions. Each question was answered using a Likert scale (very dissatisfied to very satisfied). Data on procedure type, facility, radiologist interaction, health rating, survey length, and demographics were collected. The survey was implemented at 12 radiology offices. Analyses were conducted using responses from March 2018 to April 2019. Construct validation of the five dimensions was accomplished using confirmatory factor analysis (CFA). Internal consistency was examined using Cronbach and Guttman analysis. The sample included 20,736 subjects. There was strong evidence for construct validity of the five dimensions of patient experience. The CFA achieved the best fit with the five-factor model relative to other models (comparative fit index: 0.98, standardized root mean square error residual: 0.0307, root mean square error of approximation: 0.0371). There was high internal consistency (Cronbach's α 0.94, Guttman coefficient 0.93). Item analysis showed that no questions were consistently skipped. Eighty-two percent of participants said the survey was not too long. Patients reported high satisfaction on all dimensions of satisfaction across modalities and office sites. The CFA and internal consistency analyses provide evidence for this survey having good psychometric properties: construct validity for five dimensions of patient experience and high internal consistency among the items. This survey is intended to be used by, and to benefit, radiology practices and their patients.

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

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.

Lapsus-tutkimushanke: Näkökulmia lapsiperheen potilaskokemukseen

Lasten ja nuorten sekä heidän perheidensä potilaskokemusta on tutkittu varsin vähän. Potilaskokemus on käsitteenä moniulotteinen ja monimerkityksellinen, minkä johdosta sen määritteleminen ja mittaaminen on haastavaa.&#x0D; Lapsus-tutkimushankkeessa selvitetään lapsipotilaiden ja heidän perheidensä näkökulmia sairaalakäynneistä, saaduista hoidoista ja palveluista sekä sairastamisen arjesta. Kolmivuotinen tutkimushanke on Tekesin rahoittama ja liittyy kiinteästi Uuden lastensairaalan toiminnalliseen kehittämiseen. Hankkeessa ovat mukana Aalto-yliopisto ja Tampereen Teknillinen yliopisto sekä Helsingin, Turun ja Oulun yliopistollisten sairaalojen lastenklinikat.&#x0D; Hankkeen tavoitteena on tukea lapsipotilasperheiden kokemusten huomioimista uusia sairaaloita rakennettaessa ja sairaalojen toimintaa kehitettäessä. Tutkimuksellisesta näkökulmasta keskeisimpiä tavoitteita ovat potilaskokemuksen ulottuvuuksien kuvaaminen lapsipotilaiden ja heidän perheidensä näkökulmasta, potilaskokemuksen ja arvonmuodostuksen seurantaan liittyvän metodiikan ja mittaristojen kehittäminen, sekä potilaskokemustiedon linkittäminen osaksi jatkuvaa parantamista.&#x0D; Hankkeen toteutus koostuu osatutkimuksista, joiden aiheita ovat A) Lapsipotilasperheen potilaskokemuksen ulottuvuudet ja potilaspolut, B) Potilaskokemuskyselyt vanhempien kokemusten mittaamiseksi, C) Videopäiväkirja nuorten potilaskokemusten tutkimusvälineenä, D) Valokuvamenetelmä lasten potilaskokemusten tutkimisessa, E) Ekosysteemi rakentamassa potilaskokemusta, F) Potilaspalautteen keruu ja hyödyntäminen lastensairaalassa.&#x0D; Lapsus-tutkimushankkeessa kehitetyt menetelmät ja tutkimuksesta saadut kokemukset auttavat ymmärtämään, minkälaiset asiat koetaan tärkeiksi ja arvokkaiksi, ja miten kokemustietoa voidaan kerätä ja hyödyntää lastensairaalan toiminnan kehittämisessä.

What are the most important dimensions of quality for addiction and mental health services from the perspective of its users?

There is a need to better engage service users in improving their experience with the care received in Addiction and Mental Health (A&MH). Dimensions of patient experience that are most salient to A&MH service users still remain to be properly defined from the patient perspective. This research focuses on identifying key domains of service experience important to patients of Addiction and Mental Health using patient focus groups. In addition, through a patient and family advisory committee, patients were also engaged as co-partners of the research team. The patient advisors had a major role in overseeing the research project, assisting with the thematic analysis and identifying the service domains. A total of 48 individuals (60% female; mean age = 45 years) with lived experience using A&MH services participated in the focus groups. The major themes that emerged from the focus groups led to the identification of seven dimensions of service quality: 1) access, 2) humanity of care, 3) skill and quality of staff, 4) patient engagement, 5) internal and external program communication, 6) individualized treatment and 7) continuity of care. We found that these domains were similar across all service settings including addictions. Patient advisors provided a unique “insider” perspective on the data. Identifying common aspects of service is the first phase of this study. These findings will form the framework for the development of a patient experience survey for Addiction and Mental Health.

The benefits of co-location in primary care practices: the perspectives of general practitioners and patients in 34 countries

BackgroundThere is no clear evidence as to whether the co-location of primary care professionals in the same facility positively influences their way of working and the quality of healthcare as perceived by patients. The aim of this study was to identify the relationships between general practitioner (GP) co-location with other GPs and/or other professionals and the GP outcomes and patients’ experiences.MethodsWe wanted to test whether GP co-location is related to a broader range of services provided, the use of clinical governance tools and inter-professional collaboration, and whether the patients of co-located GPs perceive a better quality of care in terms of accessibility, comprehensiveness and continuity of care with their GPs. The source of data was the QUALICOPC study (Quality and Costs of Primary Care in Europe), which involved surveys of GPs and their patients in 34 countries, mostly in Europe. In order to study the relationships between GP co-location and both GPs’ outcomes and patients’ experience, multilevel linear regression analysis was carried out.ResultsThe GP questionnaire was filled in by 7183 GPs and the patient experience questionnaire by 61,931 patients. Being co-located with at least one other professional is the most common situation of the GPs involved in the study. Compared with single-handed GP practices, GP co-location are positively associated with the GP outcomes. Considering the patients’ perspective, comprehensiveness of care has the strongest negative relationship of GP co-location of all the dimensions of patient experiences analysed.ConclusionsThe paper highlights that GP mono- and multi-disciplinary co-location is related to positive outcomes at a GP level, such as a broader provision of technical procedures, increased collaboration among different providers and wider coordination with secondary care. However, GP co-location, particularly in a multidisciplinary setting, is related to less positive patient experiences, especially in countries with health systems characterised by a weak primary care structure.

Dimensions of Patient Experience and Overall Satisfaction in Emergency Departments.

Objective:To determine the correlation between individual patient experience dimensions and overall patient satisfaction using text-based analysis of subjective comments of patients treated in emergency departments.Methods:Open-ended comments from 331 patients who visited the emergency departments of 4 hospitals were used for coding different dimensions of patient experience. Regression coefficients were calculated to assess the relationships between dimensions of patient experiences with overall satisfaction.Results:Positive and negative experience of nursing, communications, and infrastructure influence the overall satisfaction. Positive experience attributes of overall care quality influence overall satisfaction, whereas negative experience of the same does not have any influence. Further, experiences of interactions with doctors and scheduling do not have any effect on overall satisfaction in emergency departments.Conclusions:Emergency departments may get higher overall patient evaluations by focusing on positive aspects of care, nursing, communication, and infrastructure attributes. Doctors and scheduling (emergency) may be considered as expected quality attributes and so not surprising that they did not play a role in overall satisfaction.

Usability of patient experience surveys in Australian primary health care: a scoping review.

Monitoring patient experience is essential for stimulating innovation in health care and improving quality and accountability. Internationally, standardised approaches are used to collect patient experience information, but in Australian primary health care (PHC), little is known about which patient experience surveys are used and which aspects of experience they measure. This prevents routine inclusion of patient experience data in quality improvement or system performance measurement. A scoping review was undertaken to identify relevant surveys. Data on survey availability, psychometric properties, target population, method and frequency of administration were extracted. Survey items were mapped against six dimensions of patient experience described internationally. Ninety-five surveys were identified; 34 were developed for use in Australia. Surveys vary in content, size, aspects of experience measured and methods of administration. The quality of data collected and the extent to which it is used in quality improvement is unclear. Collection of patient experience data in Australian PHC is not well developed or standardised and there are few publicly available instruments. There is a need to clearly identify the purposes for which data are to be used and to develop an integrated approach that articulates these collections with other quality and performance data. Some options are discussed.

Predictors of pain following total knee arthroplasty

Predictors of pain following total knee arthroplasty

Evaluating patient experience in online health communities

Online communities that focus on health-related matters have rapidly increased in number in the last several years or so. The increasing demand from health consumers for such forums have led several leading health care organizations (HCOs), including Kaiser Permanente and Johns Hopkins, to establish online communities/discussion forums as part of their patient-support services. Patients' interactions in such HCO-led online health communities potentially add another important dimension to the overall patient experience. However, there has been limited research focus on measuring or evaluating patients' experience in such online health communities. The objective of this study was to evaluate patients' online community experience (OCE) and examine its impact on patients' attitude toward the HCO and its services. The data collection was conducted using an online questionnaire sent to consumers/patients who participated in the online health communities of three large academic medical centers: the Johns Hopkins Pathology discussion board, run by the pathology department at Johns Hopkins University; the MD Anderson Cancer survivor board, run by MD Anderson Cancer Center at the University of Texas; and the Joslin Discussion Board, run by Joslin Diabetes Center affiliated with Harvard Medical School. Confirmatory factor analysis was done to validate the four dimensions of OCE. Linear regression technique was used to validate the impact of OCE on patient attitudes. The results provide support for four dimensions of patients' OCE: pragmatic, empathic, sociability, and usability. Furthermore, all these four dimensions of OCE had a positive impact on patient's attitudes toward the HCO and its services. An understanding of the four dimensions of patient experience in online health communities and its implications on patient attitudes could help HCOs to design, deploy, and manage such online health communities more effectively.

Patient Experiences with the Preoperative Assessment Clinic (PEPAC): validation of an instrument to measure patient experiences

Presently, no comprehensive and validated questionnaire to measure patient experiences of the preoperative assessment clinic (PAC) is available. We developed and validated the Patient Experiences with the Preoperative Assessment Clinic (PEPAC) questionnaire, which can be used for quantitative measurements of patient experiences of the PAC. We adapted the National Health Service outpatient questionnaire, incorporating questions specific for anaesthesiology. To make the PEPAC appropriate for quantitative measurements, dimensions and single items suitable for statistical analysis were constructed. Each dimension consists of multiple items measuring the same aspect of care. Reliability was established by computing Cronbach's alpha coefficients. Construct validity was assessed by correlating the dimensions with the patient's overall appraisal (Pearson's r). These dimensions should explain a substantial level of variance of the patients' overall appraisal; therefore, regression analysis was performed. After a pilot phase, the questionnaire was sent to 700 consecutive patients (response 74%). Five scales measuring five dimensions of patient experiences were constructed. Cronbach's alpha ranged from 0.56 to 0.84, supporting reliability of the PEPAC. Correlations between the dimensions and patients' overall appraisal ranged from 0.22 to 0.56. Collectively, the five scales explained 51% of patients' overall appraisal. The PEPAC is a comprehensive, reliable, and validated questionnaire to measure patient experiences with the PAC. It might be a useful tool to identify the service areas of the PAC that require improvement and to determine which actions can bring about improvement.