ESHMS 2010 Ghent 26-28.08.2010

T. Brzostek1, L. Przewoźniak1, P.Brzyski1, M. Kózka1,

K.Gajda1, M.Cisek1, L. Aiken2, W. Sermeus3

1. Jagiellonian University Medical College, Krakow, Poland: Institute of Nursing and Midwifery, Department of Medical Sociology, Chair of Epidemiology and Preventive Medicine

2. University of Pennsylvania, USA

3. Catholic University Leuven, Belgium

Factors influencing patients’ willingness

to recommend hospital as a place for therapy.

Polish RN4CAST pilot study results.

ESHMS 2010 Ghent 26-28.08.2010

Patient satisfaction is an important indicator of Healthcare Quality

Started in 1994 yr.

The Centre of Monitoring Healthcare QualityThe primary goals • Education about Healthcare Quality for Teams from Health Care Service.

• Implementation and Improvement of Accreditation Process.

• Health Technology Assessment (HTA)

• Monitoring three Categories of Indicators of HealthCare Quality: medical, quality of life and patient’ satisfaction.

The PASAT program is applied by 94 hospitals and 13 outpatient clinic with accreditation of the CMHQ

Pilot study

To accomplish objectives of the RN4CAST project (

www.rn4cast.eu/en/index.php) in Poland, a pilot

study was conducted in one 24/7 acute care hospital

This presentation shows selected data of the Patient

Satisfaction Questionnaire concerning received

medical care.

Aim of the pilot study

• Assessment of quality of questionnaire in terms of

patients’ ability to understand questionnaire items

and the level of responsiveness

• Assessment of patients satisfaction expressed

in terms of willingness to recommend the hospital

as a place for therapy

Material and methods

The study sample included 119 patients hospitalized

in one hospital, in internal medicine (n= 59) and

surgical (n=66) wards, who voluntary and

anonymously agreed to participate in the study, and

filled in the questionnaire.

Survey method, self-report standardized

questionnaire.

Questionnaire

The questionnaire consisted of 14 items concerning different aspects of patients’ experiences during hospital stay:

1) respect showed by doctors (3 items) and by nurses (4 items)

2) hospital environment (2 items)

3) pharmacological management of pain (conditional, 2 items)

4) information about introduced new drug (conditional, 2 items)

5) assistance with physiological needs (conditional, 1 item) Response format: 4-item Likert scale:

1. never, 2. sometimes, 3. usually, 4. always

6) received information about possible side effects and self-care after leaving the hospital (2 items) Dichotomous response format

Background variablesType of unit, expected number of days to stay in the hospital, self-rated health, education level,

Statistical analysis

Multivariate logistic regression model – 9 models for every dimension of patient satisfaction separately

Analysis was done with SPSS 15 for Windows

Main outcome measure of patient satisfaction:„Would you recommend this hospital to your friends and family?”: definitely no, probably no, probably yes, definitely yes

Results 1

Quality of questionnaire

46% responders completed 100% of the questions

74% responders completed 90% of the questions

(missing less than 2/24 questions)

90% responders completed 80% of the questions

(missing less than 5/24 questions)

Results 2

Characteristics of the sample

Variable Category %

Education Elementary 33

Secondary 53

University 14

Self-rated health (SRH) Poor 42

Mean 17

Good 32

Expected duration of the hospital stay <=2 days 29

3-7 days 52

8+ days 19

Results 3

Percentage of patients entirely satisfied with:

1. respect showed by doctors 70

2. respect showed by nurses 53

1+2. respect showed by medical staff 67

3. hospital environment 53

4. pharmacological management of pain c 74

5. introducing new drug c 58

4+5. pharmacology c 51

6. assistance with physiological needs c 77

summary measure of satisfaction 33

7. full information about self care after hospital leaving 77

Lack of doubts when recommending the hospital: 58%

lack of satisfaction with: OR 95%CI

1. respect showed by doctors 40.5 3.58 – 457

2. respect showed by nurses 3.64 0.88 – 15.1

1+2. respect showed by medical staff 8.78 1.65 - 46.8

3. hospital environment 1.95 0.58 – 6.53

4. pharmacological management of pain c 7.46 1.15 - 48.5

5. introducing new drug c 13.4 1.75 – 103

4+5. pharmacology c 31.4 1.40 - 706

6. assistance with physiological needs c1.00 0.08 – 11.5

summary measure of satisfaction 2.77 0.36 – 21.7

Odd-ratio of having doubts when recommending the hospital related to

Results 4

Odd-ratio of having doubts when recommending the hospital

1. Patients who did not obtained full information about

self-care after leaving the hospital had higher odds

(OR=4,3) of having doubts in models regarding respect

from medical staff.

2. Patient who expected to stay in hospital from 3 to 7

days had lower odds (OR=0,2) of having doubts.

3. Patients with poor and mean SRH had higher odds

(OR=3,1) of having doubts.

Results 5

Conclusions:

• lack of respect from medical staff, especially from

physicians,

• effective pain management

• lack of full information concerning:

1. The questionnaire was well received, understood,

the response level was high and logical.

2. Factors influencing willingness to recommend the

hospital as a place for treatment are:

• introduction of the new drugs,

• possible side effects and self-care

after leaving hospital .