A Mixed-Methods Analysis of Patient Reviews of Hospital Care in England: Implications for Public Reporting of Health Care Quality Data in the United States

Lagu, Tara; Goff, Sarah L.; Hannon, Nicholas S.; Shatz, Amy; Lindenauer, Peter K.

doi:10.1016/s1553-7250(13)39003-5

Cited by 60 publications

(84 citation statements)

References 26 publications

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“…28 There are no published data assessing whether unprompted consumer criteria for hospital quality are similar to domains in structured surveys; nor data assessing narratives from friends and families, separate from patients. Lastly, the original HCAHPS developers chose survey domains based on family and patient focus groups over a decade ago 29 30 and new domains of importance to patients, friends and families may have emerged with subsequent healthcare system changes.…”

Section: Introductionmentioning

confidence: 99%

From the closest observers of patient care: a thematic analysis of online narrative reviews of hospitals

et al. 2015

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Objective Patient-centred care has become a priority in many countries. It is unknown whether current tools capture aspects of care patients and their surrogates consider important. We investigated whether online narrative reviews from patients and surrogates reflect domains in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) and we described additional potential domains. Design We used thematic analysis to assess online narrative reviews for reference to HCAHPS domains and salient non-HCAHPS domains and compared results by reviewer type (patient vs. surrogate). Setting We identified hospitals for review from the American Hospital Association database using a stratified random sampling approach. This approach ensured inclusion of reviews of a diverse set of hospitals. We searched online in February 2013 for narrative reviews from any source for each hospital. Participants We included up to two narrative reviews for each hospital. Exclusions: Outpatient or emergency department reviews, reviews from self-identified hospital employees, or reviews of <10 words. Results 50.0% (n=122) of reviews (N=244) were from patients and 38.1% (n=93) from friends or family members. Only 57.0% (n=139) of reviews mentioned any HCAHPS domain. Additional salient domains were: Financing, including unexpected out of pocket costs and difficult interactions with billing departments; system-centred care; and perceptions of safety. These domains were mentioned in 51.2% (n=125) of reviews. Friends and family members commented on perceptions of safety more frequently than patients. Conclusions A substantial proportion of consumer reviews do not mention HCAHPS domains. Surrogates appear to observe care differently than patients, particularly around safety.

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Section: Introductionmentioning

confidence: 99%

From the closest observers of patient care: a thematic analysis of online narrative reviews of hospitals

et al. 2015

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“…However, patient experiences are multidimensional, and adding qualitative analysis provides useful information for determining specific areas for quality improvement. Using a mixed-method approach allows findings to be compared and permits a more complete understanding of the issues that are important to patients 19. Closed-ended questions on patient evaluation require respondents to decide on one response category, with a cultural positivity bias pushing towards the most positive categories 9.…”

Section: Introductionmentioning

confidence: 99%

Patient evaluation of hospital outcomes: an analysis of open-ended comments from extreme clusters in a national survey

2014

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ObjectivesA recent study identified patients in six distinct response groups based on their evaluations of outcomes related to overall satisfaction, malpractice and benefit of treatment. This study validates the response clusters by analysing and comparing open-ended comments from the extreme positive and extreme negative response groups.DesignQualitative content analysis.SettingData from open-ended comment fields provided by patients who completed a national patient-experience survey carried out in Norway in 2011. 10 514 patients responded to the questionnaire and 3233 provided comments. A random sample of 50 open-ended comments from respondents representing cluster 1 (‘excellent services’), cluster 5 (‘services have clear improvement needs’) and outliers (‘very poor services’) was reviewed.Results3 distinct patient profiles were identified. More than half of the comments in cluster 1 included descriptions of positive healthcare experiences, one addressed patient safety issues. Only 1 of the comments in cluster 5 was positive, and 12 were related to safety. All comments from the outliers were negative, and more than three-quarters reported experiences related to malpractice or adverse events. Recurring themes did not differ significantly between the three respondent groups, but significant differences were found for the descriptions and severity of the experiences.ConclusionsPatients in negative response groups had distinct and much poorer healthcare descriptions than those in the extreme positive group, supporting the interpretation of quality differences between these groups. Further research should assess ways of combining statistical cluster information and qualitative comments, which could be used for local quality improvement and public reporting.

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“…It was also found that there is significant relationship between satisfaction and individual characteristics such as age, education, occupation and marital status [17].…”

Section: Resultsmentioning

confidence: 95%

“…In recent years, several studies have been conducted in the field of patient satisfaction from hospital services and since a fundamental element of providing service in a society is satisfaction of clients is, therefore, attention to this issue and monitoring is completely justifiable [17]. Because behavior of customer and consumer (patient) is a sign of quality of service, satisfaction rate and ultimately identifying strengths and weaknesses in service delivery, so investigating views of consumers and the factors affecting their satisfaction and taking measures in line with these affecting factors can be effective in enhancing patient satisfaction index [18].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Patient Satisfaction and Factors Affecting It: A Review of the Literature

Farzianpour¹,

Byravan²,

Amirian³

2015

Health

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Patient satisfaction with hospital services is one of the most important indicators of effectiveness and quality of hospital services. Patient satisfaction surveys can provide valuable data for evaluating the current status, awareness of quality and quantity of process improvement programs and quality improvement to health managers and policy makers. The present study discusses previous studies conducted in this area, and presents recommendations to improve patient satisfaction. The method of this study is review. Selected papers were identified by searching keyword in Persian and English in different databases and after applying the inclusion criteria, 19 studies were extracted and analyzed. 23,793 patients in 12 studies entered into this research were investigated. Generally, satisfaction of the patients in this study was estimated at an average level. Continuous evaluation of patient satisfaction and identification of the factors affecting it requires establishment of comprehensive and accurate data system in this area; that by application of the results of previous studies steps can be taken to improve patient satisfaction. Patients' satisfaction in Iran, compared with other countries, is desirable. In addition, the overall satisfaction of patients in recent years has increased compared to previous years and the reason can be measures like different ways of improving the quality, customer orientation, and applying the results of research conducted in this area.

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A Mixed-Methods Analysis of Patient Reviews of Hospital Care in England: Implications for Public Reporting of Health Care Quality Data in the United States

Cited by 60 publications

References 26 publications

From the closest observers of patient care: a thematic analysis of online narrative reviews of hospitals

From the closest observers of patient care: a thematic analysis of online narrative reviews of hospitals

Patient evaluation of hospital outcomes: an analysis of open-ended comments from extreme clusters in a national survey

Evaluation of Patient Satisfaction and Factors Affecting It: A Review of the Literature

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