Assessing the impact of general practitioner team service on perceived quality of care among patients with non-communicable diseases in China: a natural experimental study

Rationale and Objectives: Patients with chronic diseases re-admitted for acute events are associated with a high use of hospital resources and represent a challenge for healthcare systems. In such cases, follow-up interventions at discharge can be effective. The widespread adoption of follow-up procedures not involving telemonitoring may greatly decrease re-admissions rates without the costs associated with telemedicine. To assess the impact of a structured follow-up programme on patient-perceived healthcare quality, treatment adherence, re-admissions and Emergency Department attendances.Methods: This was a before and after study of 242 patients at risk of re-admission for chronic obstructive pulmonary disease (COPD) or heart failure (HF), recruited between 1st July 2009 and 30th June 2010 at Donostia Tertiary University Hospital (Gipuzkoa, Spain). The follow-up ended on 30th December 2010. The intervention involved identifying independent re-admitted patients, providing personalised information and a direct number to call in the event of clinical worsening, assigning specialists and liaison nurses, structured follow-up by telephone and appointments and contact with general practitioners. Patient perceived quality of care estimated was analyzed using a focus group technique. To assess the number of re-admissions and the Emergency Department attendances we estimated the relative risk reduction as a percentage and corresponding 95% confidence intervals.Results: In terms of perceived quality of care, the most valued elements were related to having an assigned doctor/nurse and easy access in the event of worsening. Overall, 97.9% of patients reported full adherence to treatment (95% CI: 95.4-98.83).Hospital bed days and Emergency Department attendances decreased by 60.7% (95% CI: 58.7-62.7) and 77% (95% CI: 73.2-80.3), respectively.Conclusions: The intensive multidisciplinary care programme can reduce Emergency Department attendances and improve perceived quality of care in patients with HF and COPD.

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Quality of Care among Non-Communicable Diseases (NCDs) Service Delivery in South Asia: A Systematic Rapid Review

10.21203/rs.3.rs-155655/v1 ◽

2021 ◽

Author(s):

Saraban Ether ◽

K M Saif-Ur-Rahman

Keyword(s):

Cardiovascular Disease ◽

Quality Of Care ◽

South Asia ◽

South Asian ◽

Communicable Diseases ◽

Rapid Review ◽

Cochrane Library ◽

Non Communicable Diseases ◽

The Impact

Abstract Background: South Asia is facing the challenges of non-communicable diseases (NCDs) which are getting doubled due to the low quality of care (QoC) around NCD services. This systematic rapid review aims to unpack available approaches to establish the quality of care around NCD services and the impact of those approaches to reduce NCD burden in South Asian countries. Methods: Three electronic databases (Medline, Embase, and the Cochrane Library) were searched. Studies published from 1st January 1990 to 31st December 2020 were included. Studies written in English in the South Asian context following any research design about four major NCDs (cancer, diabetes, cardiovascular disease, chronic respiratory disease), and interventions to achieve QoC were included. Data extraction was done using a pre-specified form. A narrative synthesis was conducted for analyzing the extracted information. This systematic rapid review is registered in PROSPERO (International prospective register of systematic reviews) - CRD42020157401.Results: Among 829 identified studies 13 were included in the review for in-depth analysis. Most of the studies focused on cancer followed by diabetes and cardiovascular disease. Community and clinic-based screening, NCD care education, NCD specialized corner or hospital, and a follow-up system ensure patient satisfaction, accessibility, early detection, timely referral, and help to reduce disease severity, mortality rate, and incidence of the new disease.Conclusions: The effective interventions for improving QoC around NCD services can be scaled up in different settings in South Asia to reduce the burden of NCDs.

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Perceived quality of care among people with type 2 diabetes mellitus in the north east region of peninsular Malaysia

BMC Public Health ◽

10.1186/s12889-021-10320-y ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Noorfariza Nordin ◽

Suhaily Mohd Hairon ◽

Najib Majdi Yaacob ◽

Anees Abdul Hamid ◽

Seoparjoo Azmel Mohd Isa ◽

...

Keyword(s):

Quality Of Care ◽

Perceived Quality ◽

Peninsular Malaysia ◽

North East ◽

The North ◽

East Region ◽

Perceived Quality Of Care ◽

Significant Difference

Abstract Background People with type 2 diabetes mellitus (T2DM) are best managed by a chronic care model that is associated with enhanced quality of care and improved patient outcome. Assessing patients’ perceived quality of care is crucial in improving the healthcare delivery system. Hence, this study determined the perceived quality of care among people with T2DM and explored its associations with (i) sociodemographic and clinical characteristics and (ii) types of healthcare clinics to guide future planning. Methods A cross-sectional study involving 20 primary healthcare clinics in the North East Region of Peninsular Malaysia and people with T2DM as the sampling unit was conducted from February to May 2019. The pro forma checklist, interview-guided Skala Kepuasan Interaksi Perubatan-11, and Patient Assessment of Chronic Illness Care (Malay version; PACIC-M) questionnaire were used for data collection. Univariate analysis and linear regression were used to determine the status of perceived quality of care and the factors associated with the perceived quality of care, respectively. Results Overall, data from 772 participants were analyzed. The majority was from the Malay ethnic group (95.6%) with a mean (standard deviation [SD]) glycated hemoglobin A1c (HbA1c) level of 8.91% (2.30). The median (interquartile range [IQR]) of the number of medical officers available at each clinic was 6 (7), with Family Doctor Concept (FDC) clinics having a higher number of medical officers than non-FDC clinics (p = 0.001). The overall mean (SD) PACIC-M score was 2.65 (0.54) with no significant difference between scores of patients treated in the two clinic types (p = 0.806). Higher perceived quality of care was associated with lower number of medical officers (adjusted regression coefficient [Adj.β], − 0.021; p-value [p], 0.001), and greater doctor–patient interaction in all domains: distress relief (Adj.β, 0.033; p, < 0.001), rapport (Adj.β, 0.056; p, < 0.001), and interaction outcome (Adj.β, 0.022; p, 0.003). Conclusion Although there was no significant difference found between clinic type, this study reflects that patients are comfortable when managed by the same doctor, which may support a better doctor-patient interaction. A larger specialized primary care workforce could improve diabetes care in Malaysia.

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Perceived quality of surgical care in association with patient-related factors and correlation to reported postoperative complications in Finland: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2020-037708 ◽

2020 ◽

Vol 10 (11) ◽

pp. e037708

Author(s):

Ira Helena Saarinen ◽

Jaana-Maija Koivisto ◽

Antti Kaipia ◽

Elina Haavisto

Keyword(s):

Quality Of Care ◽

Postoperative Complications ◽

Cross Sectional Study ◽

Perceived Quality ◽

Living Alone ◽

Sectional Study ◽

Related Factors ◽

Cross Sectional ◽

Perceived Quality Of Care

ObjectiveTo study if patient-related factors are associated with patient-evaluated quality of care in surgery. To examine if there is an association with postoperative complications and patient-evaluated low quality of care.DesignA correlation cross-sectional study, in addition, a phone call interview at 30 days postoperatively to examine complications.SettingThe data on patients admitted for non-cardiac general and orthopaedic surgery at a central hospital in Southwestern Finland were collected in two phases during an 8-month period.Participants436 consecutive consenting and eligible in-ward non-cardiac general surgery and orthopaedic surgery adult patients. Ambulatory, paediatric and memory disorder patients were excluded. 378 patients completed the questionnaire (Good Nursing Care Scale for Patients (GNCS-P)).MethodsPerceived quality of care was examined by the GNCS-P questionnaire. Patient-related factors were obtained from electronic patient records and questionnaire. A telephone interview related to postdischarge complications was conducted 30 days after discharge.Main outcome measuresPatient evaluation of quality of care at discharge, its association with patient-related factors and patient-reported postdischarge complications.ResultsThe overall quality was evaluated high or very high by the patients. The lowest overall quality of care rate was assessed by surgical patients living alone (p=0.0088) and patients who evaluated their state of health moderate or poor (p=0.0047). Surgical patients reporting postoperative complications after discharge evaluated lower overall quality of care (p=0.0105) than patients with no complications.ConclusionPatient demographic factors do not seem to influence the perceptions of the quality of care. Instead, subjective state of health and living conditions (living alone) may have an influence on the patient experience of quality of care. The perceived quality of care in healthcare staff technical and communication skills may have an association with reported postoperative complications.

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