No abstract

Objectives-To discover the views of patients about their experiences across the interface between primary and secondary health care, including referral from general practitioners, outpatient and inpatient care, discharge, and aftercare. Design-A qualitative study involving individual and focus group interviews of patients and interviews of carers. Subjects-33 patients who had attended at least one outpatient appointment or had been an inpatient between two and four months previously, and eight carers of patients with chronic conditions. Setting-Three acute hospitals and one community health service in Leicestershire. Main outcome measures-Common themes in the views of patients and carers towards their experiences of care. Results-Five themes emerged. The first four were: "getting in" (access to appropriate care), "fitting in" (orientation of care to the patient's requirements), "knowing what's going on" (provision of information), and "continuity" (continuity of staV and coordination and communication among professionals). The fifth theme was "limbo" (diYculty in making progress through the system), which was influenced by failures in care in relation to the other four themes. Conclusions-The concept of progress is central to patients' views of care. It involves both progress through the healthcare system and progress towards recovery or adjustment to an altered health state. Patients' views on how well they progress through the healthcare system may be an appropriate indicator for monitoring health service performance.

via the Internet (amc@leicester.ac.uk).Summary.-Using a self-administered questionnaire, 227 respondents rated service elements associated with a restaurant, retail store, or public transport company on several 5-point and 7-point rating scales. Least-squares regression showed that linear equations for estimating 7-point from 5-point and 5-point from 7-point ratings explained over 85% of the variance and fitted the data almost as well as higher-order polynomials and power functions. In a cross-validation on a new data set, the proportion of variance explained fell to about 76%. Functionally inverse versions of the derived linear equations were calculated for the convenience of researchers and psychometricians.

Mystery customer research is a technique of quality assessment in the retail sector, where it is called mystery shopping, and also in the service sector. It is growing rapidly in popularity, but research in cognitive psychology suggests a number of potential threats to the reliability and validity of data collected through its use.In particular, various factors associated with the encoding, storage, and retrieval of information by mystery customer assessors are likely to influence the accuracy of the results, and individual differences between assessors should also be taken into account in designing mystery customer surveys. A number of specific recommendations designed to minimize errors arising from memory failures and distortions are outlined and discussed.