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首页> 外文期刊>International Journal for Quality in Health Care >Involving patients in detecting quality gaps in a fragmented healthcare system: development of a questionnaire for Patients' Experiences Across Health Care Sectors (PEACS)
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Involving patients in detecting quality gaps in a fragmented healthcare system: development of a questionnaire for Patients' Experiences Across Health Care Sectors (PEACS)

机译：让患者参与零散的医疗保健系统中的质量差距检测：针对患者跨医疗保健部门的经历（PEACS）制定问卷

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Objective. The purpose of this study was to develop and validate a generic questionnaire to evaluate experiences and reported outcomes in patients who receive treatment across a range of healthcare sectors. Design. Mixed-methods design including focus groups, pretests and field test. Setting. The patient questionnaire was developed in the context of a nationwide program in Germany aimed at quality improvements across the healthcare sectors. Participants. For the field test, 589 questionnaires were distributed to patients via 47 general practices. Main Measurements. Descriptive item analyzes non-responder analysis and factor analysis (PCA). Retest coefficients (r) calculated by correlation of sum scores of PCA factors. Quality gaps were assessed by the proportion of responders choosing a response category defined as indicating shortcomings in quality of care. Results. The conceptual phase showed good content validity. Four hundred and seventy-four patients who received a range of treatment across a range of sectors were included (response rate: 80.5%). Data analysis confirmed the construct, oriented to the patient care journey with a focus on transitions between healthcare sectors. Quality gaps were assessed for the topics 'Indication', including shared-decision-making (6 items, 24.5-62.9%) and 'Discharge and Transition' (10 items; 20.7-48.2%). Retest coefficients ranged from r=0.671 until r= 0.855 and indicated good reliability. Low ratios of item-non-response (0.8-9.3%) confirmed a high acceptance by patients. Conclusions. The number of patients with complex healthcare needs is increasing. Initiatives to expand quality assurance across organizational borders and healthcare sectors are therefore urgendy needed. A validated questionnaire (called PEACS 1.0) is available to measure patients' experiences across healthcare sectors with a focus on quality improvement.
机译：目的。这项研究的目的是开发和验证通用问卷，以评估在各个医疗保健部门接受治疗的患者的经历和报告的结局。设计。混合方法设计，包括焦点小组，预测试和现场测试。设置。患者问卷是在德国的一项全国计划的背景下开发的，旨在改善整个医疗保健行业的质量。参加者对于现场测试，通过47种常规做法向患者分发了589份问卷。主要测量。描述性项目分析无响应者分析和因素分析（PCA）。通过PCA因子总和的相关性重新计算系数（r）。通过选择响应类别的响应者比例来评估质量差距，响应类别定义为指示护理质量的缺陷。结果。概念阶段显示出良好的内容有效性。纳入了在各个部门接受了一系列治疗的744例患者（响应率：80.5％）。数据分析证实了该结构是针对患者护理旅程的，侧重于医疗保健部门之间的过渡。对“指示”主题的质量差距进行了评估，包括共同决策制定（6个项目，占24.5-62.9％）和“出院与过渡”（10个项目; 20.7-48.2％）。重新测试系数的范围从r = 0.671到r = 0.855，表明可靠性良好。低的项目无回应率（0.8-9.3％）证实了患者的高度接受。结论具有复杂医疗保健需求的患者数量正在增加。因此，迫切需要采取举措，以跨组织边界和医疗保健部门扩大质量保证。可以使用经过验证的问卷（称为PEACS 1.0）来衡量患者在整个医疗保健部门的体验，重点是提高质量。

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