Proposed Topic (Most preferred): :
Clinical Safety and Quality Service III (Projects aiming at quality service to patients and their carers)
Proposed Topic (Second preferred): :
Enhancing Partnership with Patients and Community (Projects initiated to engage patients / carers / community to improve efficiency / quality of care)
Authors (including presenting author) :
Wong ELY(1), Ma JCH(1), Cheung AWL(1), Hung CT(1), Yeoh EK(1)
Affiliation :
(1) Centre for Health Systems & Policy Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong SAR, China
Introduction :
Patient-centred care requires a collaborative effort from health institutions, healthcare professionals and patients in the health system. Patient-reported experience measures can be used to capture a snapshot of the healthcare experience from the patient’s perspective.
Objectives :
To understand patient-reported experiences in order to pinpoint specific actions to improve that drive patient-centred care processes which will ultimately lead to high-quality of care.
Methodology :
Responses were retrieved from the 2021 Specialist Outpatient Experience Survey for secondary data analysis. 47 evaluative items assessing different junctures of the patient journey were selected and coded into a 7-domain patient-centred care framework for analysis, including: 1) accessibility to care, 2) trust and respect, 3) information provision, 4) patient safety, 5) communication skills, 6) patient involvement, and 7) effectiveness. Items that were missing 45% or more responses were excluded as these items were less relevant to the majority of participants, thus leaving 30 items for final analysis. Included items with missing responses were then imputed using multiple imputations by chained equations. Likert-like responses were standardized so that each item would have a mean of 0 and a standard deviation of 1. Logistic regression models were used to evaluate each domain against a dichotomized overall patient experience rating with a rating of 8 or above indicating satisfactory experience. Items with the highest odds ratio (OR) within respective domains were included in the final pooled regression model.
Result & Outcome :
Of the total of 13,393 responses, 69.1% rated 8 or above in overall patient experience. Across 7 domains, the strongest indicators were related to clinic waiting time (accessibility; OR=1.35, p< 0.001), hygiene (patient safety; OR=1.30, p< 0.001), knowledge of medical history (communication; OR=1.37, p< 0.001), adequate discussion time during consultation (patient involvement; OR=1.65, p< 0.001), overall confidence in clinician (trust and respect; OR=1.87, p< 0.001), information on danger signals (information provision; OR=1.70, p< 0.001), and resolution of main clinical concern (effectiveness; OR=1.92, p< 0.001). In the final pooled model, trust and effectiveness domains were the strongest indicators of patient experience rating (OR = 1.53 [95% CI = 1.45-1.61], p< 0.001; OR = 1.46 [95% CI = 1.40-1.53], p< 0.001, respectively). Meanwhile, all other domains also had significantly positive predictive power for patient experience (accessibility, OR=1.22; safety, OR=1.20; communication, OR=1.12; involvement, OR=1.34; information provision, OR=1.35). The results suggest that placing focus on institutional effectiveness and patient-provider trust can enhance the overall perception of service across public specialist healthcare.
