Healthcare Quality from Professional and Patient’s Perspectives：An Exploratory Study
Date Issued
2012
Date
2012
Author(s)
Chang, Ling
Abstract
Background
Under the national health insurance (NHI) system in Taiwan, patients are free to choose any healthcare providers they prefer for services. Along with the development of “patient-centered care”, quality of care from patient’s perspectives has received increasing attention. Traditionally, healthcare quality was mainly assessed from professional perspectives. Hospital accreditation is a comprehensive and systematic evaluation for hospital care quality in Taiwan. Since 2007, the accreditation system has incorporated “process measures” to better achieve the core value of patient-centered care. Both of the information from patient reported healthcare quality or hospital accreditation level are important sources for patients while choosing a preferred healthcare provider.
Objectives
The objective of this study was to evaluate the association between healthcare quality from patient’s perspective and professional perspective.
Materials and Methods
Data for this study came from two data sources. First, a survey of discharged patient (reporting hospital quality) conducted on 2011 was used as the source of patient’s perception of healthcare quality. Second, an administrative data of hospital accreditation from 2007 to 2010 was used as the source of professional perspective. The two data files were combined and analyzed.
The measurement of patient perceived quality of care in this study was the “patient reported hospital quality, PRHQ” which was a verified, structured questionnaire. Traditional quality indicators used in the study included “physician to bed ratio” “resident to bed ratio”, “nurse to bed ratio”, “RNs to nurse ratio”, “net mortality rate”, and “occupancy rate”. The process measures of quality included measurements about interpersonal quality of healthcare.
Disscussion and Conclusion
Major results of this study were as follows. First, several traditional quality indicators such as “resident to bed ratio”, “nurse to bed ratio” , “RNs to nurse ratio”, and “occupancy rate”, and several process measures were associated with the score of PRHQ. However, all of these professional measures were closely associated with the scale of the hospital and could account for only a minor portion of the variance in PRHQ scores. Moreover, we also found that quality of the nursing staff was more important to patient’s perception of nursing performance than quantity of nursing staff. These findings implied that the measures from patient perspectives and from professional perspectives might be two independent dimensions for measuring quality of hospital care. Providing quality information from various perspectives might facilitate patient’s selection of healthcare providers and improve quality of care via market competition.
Subjects
Quality of Healthcare
Hospital Accreditation
Patient perspectives
Type
thesis
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