Journal of health services research & policy
-
J Health Serv Res Policy · Apr 2014
Assessing decision quality in patient-centred care requires a preference-sensitive measure.
A theory-based instrument for measuring the quality of decisions made using any form of decision technology, including both decision-aided and unaided clinical consultations is required to enable person- and patient-centred care and to respond positively to individual heterogeneity in the value aspects of decision making. Current instruments using the term 'decision quality' have adopted a decision- and thus condition-specific approach. We argue that patient-centred care requires decision quality to be regarded as both preference-sensitive across multiple relevant criteria and generic across all conditions and decisions. ⋯ MyDecisionQuality, which is a web-based generic and preference-sensitive instrument, can constitute a key patient-reported measure of the quality of the decision-making process. It can provide the basis for future decision improvement, especially when the clinician (or other stakeholders) completes the equivalent instrument and the extent and nature of concordance and discordance can be established. Apart from its role in decision preparation and evaluation, it can also provide real time and relevant documentation for the patient's record.
-
J Health Serv Res Policy · Apr 2014
Impact on hospital performance of introducing routine patient reported outcome measures in surgery.
To determine the impact of introducing patient reported outcome measures (PROMs) on the selection of patients for surgery and on outcome for four elective operations (hip replacement, knee replacement, varicose vein surgery and groin hernia repair). ⋯ The minimal impact that the routine use and feedback of PROMs had on provider behaviour during the initial years suggests that more attention needs to be paid to how results are communicated and to the provision of advice as to what action may be taken.
-
J Health Serv Res Policy · Apr 2014
Development and validation of a patient satisfaction questionnaire for outpatients attending health centres in North Indian cities.
With the mandate of the Indian Government to improve health services for the population, improving patients' satisfaction with outpatient department (OPD) services is vital. Many scales developed in Western societies to assess patient satisfaction may not be appropriate to the Indian health care system. The aim of this study was to develop and conduct initial psychometric testing of a satisfaction questionnaire for patients attending OPDs in North India. ⋯ NIOPDSS appears to be a reliable and valid measure of patient satisfaction for patients attending OPDs in North India. Further research should be carried out with different outpatient populations to assess the wider performance of the questionnaire.
-
J Health Serv Res Policy · Oct 2013
Choosing health: qualitative evidence from the experiences of personal health budget holders.
Personal health budgets were piloted in the English National Health Service between 2009 and 2012. Semi-structured interviews with a sub-sample of early budget holders aimed to explore their experiences of receiving and using a budget. ⋯ Patients' experiences offer valuable insights for the roll-out of personal health budgets beyond the pilot phase. Flexibility in how budgets are used may allow maximum benefits to be derived. Clear information about what budgets can and cannot be used for, with suggestions offered, will be useful. People with newly diagnosed or recent sudden onset conditions may need more help to plan their support, but all budget holders are likely to benefit from regular contact with staff for reassurance and continued motivation.
-
J Health Serv Res Policy · Oct 2013
Impact of deprivation on occurrence, outcomes and health care costs of people with multiple morbidity.
This study aimed to estimate the impact of deprivation on the occurrence, health outcomes and health care costs of people with multiple morbidity in England. ⋯ The higher incidence of disease, associated with deprivation, channels deprived populations into categories of multiple morbidity with a greater prevalence of depression, higher mortality and higher costs. This has implications for the way that resources are allocated in England's National Health Service.