Journal of Healthcare Quality Research最新文献

Introduction: Primary health care is essential in a well-designed health system. A way of approaching the quality of an institution or service is evaluating different aspects like accessibility, treatment, satisfaction, and efficiency. The COVID-19 pandemic caused substantial disruptions in health systems. The present work focused on assessing the evolution of the experience of patients. It analyzed its relationship with various factors of the centers and the professionals' quality of life.

Methods: Retrospective quantitative study through a survey carried out in Catalonia evaluating the experience of users in relation to primary health care services. Results from years 2015, 2018, 2021 and 2022 are included in the study.

Results: Users from 370 centers were included in the study. The highest scores were registered in dimensions as environment and information (more than 90%), while accessibility was the worst scored dimension (mean 65.19). Global satisfaction scores were significantly higher in 2015 and 2018 and dropped the following years showing the impact of the COVID-19 pandemics.

Conclusion: The evolution of the patient experience in Catalonia shows a progressive decrease from the first edition in 2015 to the most recent edition in 2022, aggravated by the COVID-19 pandemic. During the pandemic, all the characteristics of primary care were affected, and they are beginning to recover. The resilience that primary care has shown during the pandemic contrasts with a downward valuation of the experience of patients who have used it.

Introduction: The aim of the present study was to identify information and educational needs of neurological inpatients during residential rehabilitation from the caregivers' perspective. On top of that, it was important to acknowledge the conceptual framework underlying the complexity of needs, for the development in future research of an early identification of caregiver's information needs assessment tool. This preliminary study will allow to define the dimensions on which to measure caregiver needs and the quality of care provided to the patients and their families.

Material and methods: Focus groups of family caregivers of inpatients admitted to the Neurorehabilitation Units by the ICS Maugeri Institutes were conducted to explore the caregivers needs. All focus groups were tape-recorded and contemporaneous notes made. The tapes were transcribed and thematic analysis was used to develop categories of needs. To ensure consistency between groups, a semi-structured schedule was used to guide the focus groups.

Results: In the analysis of the statements extracted from the transcripts we defined five main themes of information needs expressed from caregivers: education, hospital care organization, legal and social care management and emotional or psychological support.

Conclusion: The results provided the identification of the domains essential for the development of a questionnaire that measures the complexity of the caregiver's information needs during residential rehabilitation. The caregivers' statements expressed in the focus groups allowed to identify five main kinds of needs. Moreover, some suggestions and ideas to improve the information and education materials to satisfy these needs emerged from caregivers and health professionals during team meetings.

Objective: To improve the safety's management in the urology paediatric surgical process of the Ambulatory Major Surgery Unit (AMSU) through the use of this tool.

Material and methods: Observational study lasting 9 months divided into a PRE-period for collecting information on the safety indicators defined by the team and reflected in the Pulse Point Arrow, using the "Hoja de Ruta", an intervention period and a POST collection stage of the same information.

Results: In both periods, a total of 1464 "Hojas de Ruta" were collected in the CMA unit, 55.8% of the total corresponding to the PRE-period, and the rest to the POST. The selected indicators improved significantly, highlighting the correct placement of bracelets, bed assignment, allergy registration, and administration of preoperative treatment.

Conclusions: The use of new management tools in healthcare systems is essential for improving healthcare processes and achieving better health outcomes. In our experience the introduction of Pulse Point Arrow improved results of surgical safety of the paediatric patient.

Objective: Democratise healthcare and research through a model that ensures the participation of patients and professionals.

Method: Weaknesses are analysed and corrections are articulated with a model through biweekly meetings between the hospital's citizen attention and healthcare management.

Results: The resulting model is proactive in nature, deployed between November-2021 and December-2023 and had three elements: Information, Co-creation and Strategy (ICE). The Information is materialized with: an Association Attention Office (AAO) and an Easy Reading Commission (ERC). Co-creation is organized through Stable Work Commissions (SWC) formed by professional-patient. The Strategy that is materialized through a Strategic Plan for institutional participation and a Strategic Committee for participation. The AAO has registered 304 entities and managed 112 projects. The ERC has evaluated 41 documents in 2023. 13SWCs related to therapeutic areas were generated where 108 professionals and 101 patient representatives participated and 42 objectives were agreed upon, working on templates for informative documents, guides or organizing informative days. The Strategic Participation Plan is translated into 8lines with objectives and actions, creating the Strategic Participation Committee as the governing body.

Conclusions: The ICE-VH model is a replicable opportunity to implement patient and professional participation in any hospital and improve person-centered care by incorporating the values and preferences of all stakeholders.

Introduction: Measuring social value has always been a challenge for organizations that generate such value, including foundations, NGOs, social enterprises, and governmental entities. Often, the benefits of these initiatives are perceived as intangible or long-term, making them difficult to quantify. Assessing social value demonstrates the impact of investments and accountability to stakeholders.Healthcare organizations should be evaluated from a broad perspective, where the quality of healthcare services is an integral part of the social value with multiple beneficiaries.This study aims to determine the economic and social impact of Hospital Santa Marina on the Bizkaia (Basque Country) population in 2023, as well as to evaluate the evolution of the hospital's social value from 2018 to 2023.

Materials and methods: The study was conducted from the multifaceted perspective of social accounting (stakeholder theory), utilizing the Social Return on Investment (SROI) tool. The economic value of the hospital (both direct and indirect) and the hospital's specific social value were calculated based on areas identified by stakeholders. Subsequently, the hospital's integrated social value and socio-emotional value were determined.

Results: The hospital contributed €34,696,178.20 to society in Direct and Indirect Market Social Value (SROI), and the Non-Market Social Value amounted to €119,758,230.71. This generated an integrated social value of the hospital of €154,454,408.91, which, considering the satisfaction index for the year 2023 was 0.9805, leads to a socio-emotional value of €211,998,238.76.

Conclusions: Hospital Santa Marina generates significant economic value for the society, beyond its direct contribution to the population's health. These findings underscore the importance of adopting a broader perspective on health and highlight the role of healthcare institutions as drivers of sustainable development.

Objective: This study assesses what factors determine citizens' preferences for a public or private hospital (assuming the choice is free of charge) according to the severity of the disease.

Material and method: A web-based discrete choice experiment was carried out with 1777 individuals distinguishing between a control group (posed with a simple choice for each health condition) and added information for respondents of the treatment groups (distance, waiting time, advice from the family doctor, and recommendations from the social context). The relevance of these factors in relation to the severity of one's illness is investigated. The outcome variable is the choice of a public versus a private hospital for the treatment of a health issue of a different severity.

Results: The severity of the health issue has a moderator effect on the additional information for the treatment groups. Waiting time has a direct positive impact on the patient's preferred choice for a private hospital both for severe and non-severe health issues. Distance to the hospital and the family doctor's recommendation positively impact the preferred choice for a private hospital for non-severe health issues but not for severe health issues. Covariates like gender and age are not relevant in explaining the effects of the treatments, and educational level has a positive impact on one of the treatments: advice from the patient's environment. Satisfaction with public hospitals has a positive impact on all treatments.

Conclusions: Results indicate that waiting time is a key factor in choosing a private hospital against the majority-stated preference for a public hospital.

Introduction: It is important to determine the health-related quality of life (HRQoL) to devise population-based cost-effective service delivery models. The present study aimed to evaluate the HRQoL of patients with refractive errors (RE) using generic and vision-specific instruments, identify the determinants of HRQoL, and examine the validity between the quality-of-life instruments for refractive errors.

Methods: Face-to-face interviews were conducted with 515 participants with RE using generic as well as vision-specific HRQoL measures. Mean EuroQol-five dimensions-five levels (EQ-5D-5L) utility value, National Eye Institute-Visual Function Questionnaire-25 (NEI-VFQ-25) composite score, and EuroQol-Visual analogue scale (EQ-VAS) score were computed, and determinants of quality of life were determined using generalized linear regression model. The validity between generic and disease-specific measures was ascertained using Pearson's coefficient.

Results: The mean EQ-5D-5L utility score for patients with RE was estimated as 0.72 (95% CI: 0.70-0.75). The mean NEI-VFQ-25 composite score and EQ-VAS score were 71.3 (95% CI: 69.8-73), and 74.7 (95% CI: 73.4-76.1), respectively. Visual acuity, gender, and presence of co-morbidities were significantly associated with quality of life. The concurrence between the generic and vision-specific instruments was found to be low to moderate.

Conclusion: The findings of the study indicate the importance of the value of quality of life for patients with RE, which could be taken into account by health administrators, doctors and researchers to carry out economic evaluations, since these measures provide a basis for an evaluation more precisely the impact of RE and guide the determination of efficient ways to alleviate the burden of treatable visual impairment. More research is required to explore the potential integration of a vision component, the sixth dimension, into the EQ-5D-5L instrument, given the moderate agreement observed between the generic and specific assessment tools.