PDF(Pubmed)
Abstract：
OBJECTIVE: Patient reported experience measures (PREMs) are tools often utilised in hospitals to support quality improvements and to provide objective feedback on care experiences. Less commonly PREMs can be used to support consumers choices in their hospital care. Little is known about the experience and views of the Australian consumer regarding PREMs nor the considerations these consumers have when they need to make decisions about attending hospital. This study aimed to explore consumer awareness of PREMs, consumer attitudes towards PREMs and the utility of PREMs as a decision-making tool in accessing hospital care.
METHODS: Qualitative study involving semi-structured interviews conducted over the phone. Participants (n = 40) were recruited from across Australia and purposively sampled according to key characteristics: holding private health insurance, > 30-years of age, may have accessed private hospital care in the past year, variety of educational and cultural backgrounds, and if urban or rural residing. Interviews were audio-recorded, transcribed, and analysed thematically.
RESULTS: Four overarching themes and six subthemes were identified from the data. Major findings were that prior awareness of PREMs was limited; however, many had filled in a PREM either for themselves or for someone they cared for following a hospital stay. Most respondents preferred to listen to experience of self or family/friends or the recommendation of their physician when choosing a hospital to attend. Participants appeared to be more interested in the treating clinician than the hospital with this clinician often dictating the hospital or hospital options. If provided choice in hospital, issues of additional costs, timeliness of treatment and location were important factors.
CONCLUSIONS: While PREMs were considered a possible tool to assist in hospital decision-making process, previous hospital experiences, the doctor and knowing up-front cost are an overriding consideration for consumers when choosing their hospital. Consideration to format and presentation of PREMs data is needed to facilitate understanding and allow meaningful comparisons. Future research could examine the considerations of those consumers who primarily access public healthcare facilities and how to improve the utility of PREMs.
METHODS: Qualitative study involving semi-structured interviews conducted over the phone. Participants (n = 40) were recruited from across Australia and purposively sampled according to key characteristics: holding private health insurance, > 30-years of age, may have accessed private hospital care in the past year, variety of educational and cultural backgrounds, and if urban or rural residing. Interviews were audio-recorded, transcribed, and analysed thematically.
RESULTS: Four overarching themes and six subthemes were identified from the data. Major findings were that prior awareness of PREMs was limited; however, many had filled in a PREM either for themselves or for someone they cared for following a hospital stay. Most respondents preferred to listen to experience of self or family/friends or the recommendation of their physician when choosing a hospital to attend. Participants appeared to be more interested in the treating clinician than the hospital with this clinician often dictating the hospital or hospital options. If provided choice in hospital, issues of additional costs, timeliness of treatment and location were important factors.
CONCLUSIONS: While PREMs were considered a possible tool to assist in hospital decision-making process, previous hospital experiences, the doctor and knowing up-front cost are an overriding consideration for consumers when choosing their hospital. Consideration to format and presentation of PREMs data is needed to facilitate understanding and allow meaningful comparisons. Future research could examine the considerations of those consumers who primarily access public healthcare facilities and how to improve the utility of PREMs.
摘要：
目的：患者报告体验措施（PREM）是医院经常使用的工具，用于支持质量改进并提供对护理体验的客观反馈。较不常见的PREM可用于支持消费者在医院护理中的选择。对于澳大利亚消费者关于PREM的经验和观点以及这些消费者在需要决定就诊医院时的考虑因素知之甚少。本研究旨在探讨消费者对PREM的认知，消费者对PREM的态度以及PREM作为获得医院护理的决策工具的效用。
方法：定性研究涉及通过电话进行的半结构化访谈。参与者（n=40）从澳大利亚各地招募，并根据关键特征进行有目的地抽样：持有私人健康保险，>30岁，可能在过去的一年里获得了私立医院的护理，各种教育和文化背景，如果居住在城市或农村。采访是录音的，转录，并按主题进行分析。
结果：从数据中确定了四个总体主题和六个子主题。主要发现是先前对PREM的认识有限；然而，许多人在住院后为自己或他们照顾的人填写了PREM。大多数受访者在选择医院就诊时更喜欢听取自己或家人/朋友的经验或医生的建议。参与者似乎对治疗临床医生比医院更感兴趣，该临床医生经常决定医院或医院的选择。如果在医院提供选择，额外费用的问题，治疗的及时性和位置是重要因素。
结论：虽然PREM被认为是协助医院决策过程的可能工具，以前的医院经验，医生和了解前期费用是消费者选择医院时最重要的考虑因素。需要考虑PREM数据的格式和表示，以促进理解并进行有意义的比较。未来的研究可以研究那些主要访问公共医疗设施的消费者的考虑因素，以及如何提高PREM的效用。
方法：定性研究涉及通过电话进行的半结构化访谈。参与者（n=40）从澳大利亚各地招募，并根据关键特征进行有目的地抽样：持有私人健康保险，>30岁，可能在过去的一年里获得了私立医院的护理，各种教育和文化背景，如果居住在城市或农村。采访是录音的，转录，并按主题进行分析。
结果：从数据中确定了四个总体主题和六个子主题。主要发现是先前对PREM的认识有限；然而，许多人在住院后为自己或他们照顾的人填写了PREM。大多数受访者在选择医院就诊时更喜欢听取自己或家人/朋友的经验或医生的建议。参与者似乎对治疗临床医生比医院更感兴趣，该临床医生经常决定医院或医院的选择。如果在医院提供选择，额外费用的问题，治疗的及时性和位置是重要因素。
结论：虽然PREM被认为是协助医院决策过程的可能工具，以前的医院经验，医生和了解前期费用是消费者选择医院时最重要的考虑因素。需要考虑PREM数据的格式和表示，以促进理解并进行有意义的比较。未来的研究可以研究那些主要访问公共医疗设施的消费者的考虑因素，以及如何提高PREM的效用。
