Patient reports of the outcomes of treatment: a structured review of approaches

Abstract

Patient reports or ratings are essential for measuring the quality of patient care. Measures designed for this purpose tend to focus on the processes and structures of care rather than the outcomes of it. The latter is arguably the most valid indicator of the quality of care patients receive. Typically this information is gathered by probing patient satisfaction with treatment as part of an investigation of satisfaction with hospital care. More recently patient ratings of the outcome of treatment have been obtained to measure treatment efficacy in clinical trials. However, a more direct approach is to ask patients to assess the benefit of treatment on their current health status. We performed a structured literature review on patient reported satisfaction with outcomes of treatment and direct patient assessments of the same. The purpose of this was to identify suitable candidate questions for a short instrument to tap patient evaluations of in-patient hospital interventions. Articles were included if they dealt with patient satisfaction or patient assessment of the outcomes of treatment. Articles were excluded if they dealt more generally with patient satisfaction with care. We identified 169 papers, 79 were included in the review. The findings of this review suggest that there are a number of benefits of directly asking patients to assess the outcome of hospital treatment. Importantly this approach reflects outcomes relevant to the patient and is also more likely to reflect patient report in routine clinical practice. There is also evidence that such approaches have face validity and construct validity. The problems associated with this approach (i.e. response bias), are those common to patient reported outcome surveys, but employing appropriate strategies can minimize them. Furthermore, employing a simple set of questions that asks patients to assess the outcomes of treatment they receive can be time and resource efficient in comparison to administering lengthy measures. This approach could be tested for potential generic use as an evaluative measure for patients in hospital settings.

Triage in an adult emergency service: patient satisfaction

“…In this regard, it is important to underscore the fact that there was a predominance of users with low education, since data observed in similar research indicate that this is a factor that has a strong influence on patient satisfaction with health institutions (28)(29)(30) . These studies also show that the level of education has a direct effect on patient satisfaction with health services, which may represent a limitation in this study, since it is known that the higher the educational level, the higher the critical tendency of the patient toward the services provided and the higher the level of quality demanded of these services which, consequently, is more likely to cause dissatisfaction on the part of this population (31)(32) .…”

Impact of clinical leadership in teams’ course on quality, efficiency, responsiveness and trust in the emergency department: study protocol of a trailing research study

“…Since the main purpose of the intervention is to improve quality of care and patient safety in the ED, it is critical that patient-centred outcomes such as experience and quality of care should be taken into account 51. A number of instruments exist to measure patient-reported outcomes, such as the Patient Judgements of Hospital Quality 53. In Norway, only a few instruments measuring patient-reported outcomes have been translated and validated.…”

“…51 A number of instruments exist to measure patient-reported outcomes, such as the Patient Judgements of Hospital Quality. 53 In Norway, only a few instruments measuring patientreported outcomes have been translated and validated. Instruments measuring satisfaction/quality of care for patients admitted to the ED are rare.…”

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