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首页> 外文期刊>Journal of Health Services Research & Policy >Factors relating to patients' reports about hospital care for coronary heart disease in England
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Factors relating to patients' reports about hospital care for coronary heart disease in England

机译：与患者有关英格兰冠心病医院治疗报告的因素有关

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Objectives: All health care providers in England are required to conduct surveys of their patients’ experience ofnhealth care. Data from such surveys contribute to the ‘star rating’ performance indicators. However, there arenconcerns that these subjective measuresmay be in uenced more by characteristics of patients than by true variationsnin the quality of care. The purpose of this paper is threefold: to determine the relationship between demographicncharacteristics and an index measure of patients’ reported experience; to explore the extent to which patients’nexperiences may be accounted for by the particular National Health Service (NHS) trust they attended; and to assessnhow meaningful a summary index is in terms of its ability to discriminate between providers.nMethods: Data from patients in the National Survey of National Health Service Patients treated for coronary heartndisease in 194 NHS trusts. Patients were sent questionnaires after discharge, with a covering letter and a prepaidnstamped addressed envelope. Up to two reminders were sent to non-responders. Multi-level linear regressionnmodels were used to estimate the extent to which patients’ experiences differed between trusts and the associationnof demographic variables with the summary index.nResults: In total, 116 872 patients were sent questionnaires, but 3399 proved to be ineligible for the survey.nResponses were gained from 84 310 (74.3% of eligible respondents). Age and sex were most strongly associated withnreported patients’ experiences. However, the actual impact of age and sex on patients’ experience is small, accountingnfor less than 3% of the variance. The proportion of the variance that was accounted for by the hospital trust in whichnpatients were treated was only 5%.nConclusions: Demographic characteristics do not appear to account for differences between hospital trusts innpatients’ experience of health care. However, there is considerable variation in patients’ experience within eachnprovider. This would suggest that summary indices of patients’ experience should not be used to rank providers,nalthough detailed information from patient surveys have a useful role in determining priorities for qualitynimprovement within individual hospitals and for assessing changes over time.
机译：目标：英格兰的所有医疗保健提供者都必须对其患者的医疗保健经历进行调查。这些调查的数据有助于“星级”绩效指标。但是，人们担心的是，这些主观措施更多地受到患者特征的影响，而不是真正的护理质量变化。本文的目的是三方面的：确定人口统计学特征与患者报告的经历指标之间的关系；探索他们参加的特定国家卫生服务（NHS）信托对患者经验的解释程度；方法：从194个NHS信托中接受全国性心脏病服务全国调查的患者中，接受冠心病治疗的患者的数据。出院后向患者发送问卷，并附上求职信和预先贴有邮戳的信封。最多有两个提醒被发送给未响应的人。结果：总共向116 872名患者发送了问卷，但有3 399名不符合调查条件，因此使用多级线性回归模型来估计患者之间的信任程度以及人口统计学变量与汇总变量之间的关联程度。 .n从84,310（占合格受访者的74.3％）中获得了答复。年龄和性别与未报告患者的经历密切相关。但是，年龄和性别对患者体验的实际影响很小，仅占差异的不到3％。由医院信托机构治疗的住院病人所占差异的比例仅为5％。n结论：人口统计学特征似乎并未解释医院信托机构住院病人的医疗保健经验之间的差异。但是，每个提供者中患者的经历差异很大。这表明，不应使用患者经验总结指数来对提供者进行排名，尽管来自患者调查的详细信息对于确定各个医院内质量改善的优先级以及评估随时间变化的变化起着有益的作用。

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