scholarly journals Correlations among measures of quality in HIV care in the United States: cross sectional study

BMJ ◽  
2007 ◽  
Vol 335 (7629) ◽  
pp. 1085 ◽  
Author(s):  
Ira B Wilson ◽  
Bruce E Landon ◽  
Peter V Marsden ◽  
Lisa R Hirschhorn ◽  
Keith McInnes ◽  
...  

Objective To determine whether a selected set of indicators can represent a single overall quality construct. Design Cross sectional study of data abstracted during an evaluation of an initiative to improve quality of care for people with HIV. Setting 69 sites in 30 states. Data sources Medical records of 9020 patients. Main outcome measures Adjusted performance rates at site level for eight measures of quality of care specific to HIV and a site level summary performance score (the number of measures for which the site was in the top quarter of the distribution). Results Of 28 site level correlations between measures, two were greater than 0.40, two were between 0.30 and 0.39, four were between 0.20 and 0.29, and the 20 remaining were all less than 0.20. One site was in the top quarter for seven measures, but no sites were in the top quarter for six or eight of the measures. Across the eight quality measures, sites were in the top quarter no more often than predicted by a chance (binomial) distribution. Conclusions The quality suggested by one measured indicator cannot necessarily be generalised to unmeasured indicators, even if this might be expected for clinical or other reasons.

BMJ Open ◽  
2020 ◽  
Vol 10 (11) ◽  
pp. e037708
Author(s):  
Ira Helena Saarinen ◽  
Jaana-Maija Koivisto ◽  
Antti Kaipia ◽  
Elina Haavisto

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.


2016 ◽  
Vol 26 (7) ◽  
pp. 559-568 ◽  
Author(s):  
Linda H Aiken ◽  
Douglas Sloane ◽  
Peter Griffiths ◽  
Anne Marie Rafferty ◽  
Luk Bruyneel ◽  
...  

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037063
Author(s):  
Marzia Lazzerini ◽  
Ilaria Mariani ◽  
Chiara Semenzato ◽  
Emanuelle Pessa Valente

ObjectivesThis study aimed to explore the association between maternal satisfaction and other indicators of quality of care (QoC) at childbirth, as defined by WHO standards.DesignCross-sectional study.SettingReferral hospital in Northeast Italy.Participants1244 consecutive mothers giving birth in the hospital participated in a survey.Data collection and analysisUnivariate analyses were performed to evaluate the association between maternal satisfaction and 61 variables, including measures of ‘provision of care’, ‘experience of care’, ‘availability of resources’ and other maternal characteristics. Exploratory factor analysis was performed to create groups of correlated variables, which were used in multivariate analysis.ResultsOverall, 509 (40.9%) of women were >35 years of age, about half (52.7%) were highly educated, most (95.2%) were married/living with partner and employed (79.3%) and about half (52.9%) were primiparous. Overall, 189 (15.2%) were not born in Italy and 111 (8.9%) did not have Italian citizenship. Most women (84.2%) were highly satisfied (score ≥7/10) with the care received. Among the 61 variables explored, 46 (75.4%) were significantly associated with women’s satisfaction, 33 with higher satisfaction and 13 with lower satisfaction. Multivariate analysis largely confirmed univariate findings, with six out of eight groups of correlated variables being statistically significantly associated with women’s satisfaction. Factors most strongly associated with women’s satisfaction were ‘effective communication, involvement, listening to women’s needs, respectful and timely care’ (OR 16.84, 95% CI 9.90 to 28.61, p<0.001) and ‘physical structure’ (OR 6.51, 95% CI 4.08 to 10.40, p<0.001). Additionally, ‘victim of abuse, discrimination, aggressiveness’ was inversely associated with the wish to return to the facility or to recommend it to a friend (OR 0.35, 95% CI 0.17 to 0.70, p<0.003).ConclusionThis study suggested that many variables are strongly associated with women’s satisfaction with care during childbirth and support the use of multiple measures to monitor the QoC at childbirth.


2017 ◽  
Vol 66 ◽  
pp. 15-22 ◽  
Author(s):  
Ramona Backhaus ◽  
Erik van Rossum ◽  
Hilde Verbeek ◽  
Ruud J.G. Halfens ◽  
Frans E.S. Tan ◽  
...  

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