Bmc Health Serv Res
-
Bmc Health Serv Res · Jun 2013
British residents' views about general practice care in France - a telephone survey.
Many studies have been published over the past decade on patients' views about the provision of health care. Though there is a high level of migration within the European Union, there are no studies on migrants' views about the provision of care in the country to which they moved. Given the wide spectrum of primary care in Europe, we hypothesised, without prejudging the outcome, that patients' confidence in the system they left, used as a proxy of 'the experience of care', may influence their preferences regarding specific aspects of care in the host country. The objective of the study was to analyse British migrants' views on general practice care in France. ⋯ British migrants' views on general practice care in France varied with the degree of confidence they had in the NHS. This finding is in line with the discussion on whether the 'experience of care' influences patient satisfaction. A better understanding of this phenomenon should provide valuable insights to make the services more responsive to the patients.
-
Bmc Health Serv Res · Jun 2013
Did hospital mortality in England change from 2005 to 2010? A retrospective cohort analysis.
There is some evidence that hospital performance in England measured by the Dr Foster Hospital Standardised Mortality Ratio (HSMR) has improved substantially over the last 10 years. This study explores mortality in-hospital and up to 30 days post-discharge over a five year period to determine whether there have been improvements in case-mix adjusted mortality, to examine if any changes are due to changes in case-mix adjustment variables such as age, sex, method of admission and comorbidity, and to compare changes between hospital trusts. ⋯ As measured by the SHMI there has been a 24% improvement in mortality in acute general trusts in England over a period of five and a half years. Part of this improvement is an artificial effect caused by changes in the depth of coding of comorbidities and other effects due to change in case-mix or non-constant risk.
-
Bmc Health Serv Res · Jun 2013
Willingness to pay for physician services at a primary contact in Ukraine: results of a contingent valuation study.
The existence of quasi-formal and informal payments in the Ukrainian health care system jeopardizes equity and creates barriers to access to proper care. Patient payment policies that better match patient preferences are necessary. We analyze the potential and feasibility of official patient charges for public health care services in Ukraine by studying the patterns of fee acceptability, ability and willingness to pay (WTP) for public health care among population groups. ⋯ Rather substantial WTP levels (between 0.9% and 1.9% of household income) for one visit to physician indicate a potential for official patient charges in Ukraine. User fees may cover a substantial share of personnel cost in the out-patient sector. The patterns of inability to pay support well designed exemption criteria based on age, income, and other aspects of economic status. The WTP patterns highlight the necessity for payments that are proportional to income. Other methodological and policy implications are discussed.