scholarly journals A qualitative study of old patients’ experiences of the quality of the health services in hospital and 30 days after hospitalization

2019 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland

Abstract Background The number of people aged 80 years and above is projected to triple over the next 30 years. People in this age group normally have at least two chronic conditions (multimorbidity). The impact of multimorbidity is often significantly greater than expected from the sum of the effects of each condition. The World Health Organization has indicated that health care systems must prepare for a change in the focus of clinical care for older people. The WHO defines health care quality as care that is effective, efficient, integrated, patient centered, equitable and safe. The degree to which health care quality can be defined as acceptable is determined by services’ ability to meet the needs of users and adapt to patients’ expectations and perceptions. This study explores experiences of the quality of the health services in hospital and the first 30 days at home after discharge by patients over 80 years of age. Method We took a phenomenological perspective to explore older patients’ subjective experiences and conducted semistructured individual interviews. Eighteen patients (aged from 82 to 100 years) were interviewed twice after discharge from hospital. The interview transcriptions were analyzed thematically. Results The patients found their meetings with the health service to be complex and demanding. They reported attempting to restore a sense of security and meaning in everyday life, balancing their own needs against external requirements. Five overarching themes emerged from the interviews: hospital stay and the person behind the diagnosis, poor communication and coordination, life after discharge, relationship with their next of kin, and organizational and systemic determinants. Conclusion According to the WHO, to deliver quality health care, services must include all six of the dimensions listed above. Our findings show that they do not. Health care focused on measurable values and biomedical inquiries. Few opportunities for participation, scant information and suboptimal care coordination left the patients with a feeling of being in limbo, where they struggled to find balance in their everyday life. Further work must be done to ensure that integrated services are provided without a financial burden, centered on the needs and rights of older people.

2020 ◽  
Vol 10 (1) ◽  
pp. 11-24
Author(s):  
Agustinus Hermino

Latar belakang: Seiring dengan perkembangan jaman, dalam beberapa tahun terakhir ini banyak perhatian yang difokuskan pada eksplorasi dampak penyakit fisik dan mental pada kualitas hidup seseorang baik secara individu maupun masyarakat secara keseluruhan. Sifat subyektif dari 'kualitas hidup' individu, merupakan konsep yang dinamis untuk diukur dan didefinisikan, tetapi bahwa secara umum dapat dipandang sebagai konsep multidimensi yang menekankan pada persepsi diri dari keadaan pikiran seseorang saat iniTujuan: penulisan ini bertujuan untuk memberikan pemahaman tentang peran masyarakat dalam memahani pentingnya kesehatan di era global ditinjau dari perspektif akademis. Pada sektor kesehatan pemahaman kesehatan menjadi sangat pentingnya karena akan menunjukkan pada kualitas hidup seseorang, tetapi hal ini tidak cukup secara individu karena diperlukan pemahaman secara menyeluruh terhadap masyarakat tentang makna kesehatan dan perawatan kesehatan.Metode: penulisan ilmiah ini adalah dengan melakukan analisa akademis dari dari berbagai sumber rujukan relevan sehingga menemukan makna teoritis baru dalam rangka menjawab tantangan yang terjadi di masyarakat.Hasil: Berdasarkan berbagai sumber rujukan yang ada, dapat disimpulkan bahwa kesehatan merupakan gaya hidup yang bertujuan untuk mencapai kesejahteraan fisik, emosional, intelektual, spiritual, dan lingkungan. Penggunaan langkah-langkah kesehatan dapat meningkatkan stamina, energi, dan harga diri, kemudian meningkatkan kualitas hidup. Dengan demikian maka konsep kesehatan memungkinkan adanya variabilitas individu. Kesehatan dapat dianggap sebagai keseimbangan aspek fisik, emosional, psikologis, sosial dan spiritual dari kehidupan seseorang. Kata kunci: masyarakat, perawatan kesehatan, kualitas hidup Society Community and Health Care in Improving Quality of LifeAbstract Background: Along with the development of the era, in recent years there has been a lot of attention focused on exploring the impact of physical and mental illness on the quality of life of a person both individually and as a whole. The subjective nature of an individual's 'quality of life' is a dynamic concept to measure and define, but that in general can be seen as a multidimensional concept that emphasizes self-perception of one's current state of mindAim: purpose of this study is to provide an understanding the role of community in understanding the importance of health in the global era from an academic perspective. In the health sector understanding of health is very important because it will show the quality of life of a person, but this is not enough individually because a comprehensive understanding of the meaning of health and health care is needed. Method: The method of scientific writing is to carry out academic analysis from various relevant reference sources, and find new theoretical meanings in order to answer the challenges that occur in society. Keyword: Community, Society,Health Care, Quality oflife Resullt : Based on various academic reference, it can be concluded that health is a lifestyle that aims to achieve physical, emotional, intellectual, spiritual, and environmental well-being. The use of health measures can increase stamina, energy, and self-esteem, then improve the quality of life. Thus the concept of health allows for individual variability. Health can be considered as a balance of physical, emotional, psychological, social and spiritual aspects of one's life. Keywords: community, health care, quality of life 


2019 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland

Abstract Background: The number of people aged 80 years and above is projected to triple over the next 30 years. People in this age group normally have at least two chronic conditions. The impact of multimorbidity is often significantly greater than expected from the sum of the effects of each condition. The World Health Organization has indicated that healthcare systems must prepare for a change in the focus of clinical care for older people. The World Health Organization (WHO) defines healthcare quality as care that is effective, efficient, integrated, patient centered, equitable and safe. The degree to which healthcare quality can be defined as acceptable is determined by services’ ability to meet the needs of users and adapt to patients’ expectations and perceptions.Method: We took a phenomenological perspective to explore older patients’ subjective experiences and conducted semistructured individual interviews. Eighteen patients (aged from 82 to 100 years) were interviewed twice after discharge from hospital. The interview transcriptions were analyzed thematically.Results: The patients found their meetings with the health service to be complex and demanding. They reported attempting to restore a sense of security and meaning in everyday life, balancing their own needs against external requirements. Five overarching themes emerged from the interviews: hospital stay and the person behind the diagnosis, poor communication and coordination, life after discharge, relationship with their next of kin, and organizational and systemic determinants.Conclusion: According to the WHO, to deliver quality healthcare, services must include all six of the dimensions listed above. Our findings show that they do not. Healthcare focused on measurable values and biomedical inquiries. Few opportunities for participation, scant information and suboptimal care coordination left the patients with a feeling of being in limbo, where they struggled to find balance in their everyday life. Further work must be done to ensure that integrated services are provided without a financial burden, centered on the needs and rights of older people.


2021 ◽  
Vol 12 (2) ◽  
pp. 539-543
Author(s):  
Christos Iliadis ◽  
Aikaterini Frantzana ◽  
Kiriaki Tachtsoglou ◽  
Maria Lera ◽  
Petros Ouzounakis

Introduction: The quality of health care services is one of the most frequently mentioned terms and concepts regarding principles of health policy and it is currently high on the agenda of National, European and International policy makers. Purpose: The purpose of this descriptive review is to investigate the correlation between quality in health services and the promotion of health care quality provided by health services. Methodology: The study material consisted of recent articles on the subject mainly found in the Medline electronic database and the Hellenic Academic Libraries Association (HEAL-Link). Results: The clinical quality of services is often difficult to be assessed by "clients" even after the service has been provided. This is due to the fact that customers experience illness, pain, uncertainty, fear and perceived lack of control. Thus, clients may be reluctant to "co-produce" because healthcare is a service they need while they may not want it and because the risk to harm their health is prominent. In the field of healthcare management, patients' perception refers to perceived quality, as opposed to the actual or absolute quality that requires critical management. This is why health care managers face constant pressure to provide qualitative health services. Conclusions: Continuous monitoring of health care services for quality assessment is essential, hence, the evaluation of patients' perceptions of quality of healthcare, has received considerable attention in recent years.


Author(s):  
Chun-Yi Liu ◽  
Pei-Tseng Kung ◽  
Hui-Yun Chang ◽  
Yueh-Han Hsu ◽  
Wen-Chen Tsai

(1) Purpose: Undesirable health care outcomes could conceivably increase as a result of the entry of new, less experienced health care personnel into patient care during the month of July (the July effect) or as a result of the less balanced allocation of health care resources on weekends (the weekend effect). Whether these two effects were present in Taiwan’s National Health Insurance (NHI) system was investigated. (2) Methods: The current study data were acquired from the NHI Research Database. The research sample comprised ≥18-year-old patients diagnosed as having a stroke for the first time from 1 January 2006 to 30 September 2012. The mortality rate within 30 days after hospitalization and readmission rate within 14 days after hospital discharge were used as health care quality indicators, whereas health care utilization indicators were the total length and cost of initial hospitalization. (3) Results: The results revealed no sample-wide July effect with regard to the four indicators among patients with stroke. However, an unexpected July effect was present among in-patients in regional and public hospitals, in which the total lengths and costs of initial hospitalization for non-July admissions were higher than those for July admissions. Furthermore, the total hospitalization length for weekend admissions was 1.06–1.07 times higher than that for non-weekend admissions; the total hospitalization length for weekend admissions was also higher than that for weekday admissions during non-July months. Thus, weekend admission did not affect the health care quality of patients with stroke but extended their total hospitalization length. (4) Conclusions: Consistent with the NHI’s general effectiveness in ensuring fair, universally accessible, and high-quality health care services in Taiwan, the health care quality of patients examined in this study did not vary significantly overall between July and non-July months. However, a longer hospitalization length was observed for weekend admissions, possibly due to limitations in personnel and resource allocations during weekends. These results highlight the health care efficiency of hospitals during weekends as an area for further improvement.


2020 ◽  
Author(s):  
Ingvild Lilleheie ◽  
Jonas Debesay ◽  
Asta Bye ◽  
Astrid Bergland

Abstract Background: The number of people aged 80 years and above is projected to triple over the next 30 years. People in this age group normally have at least two chronic conditions. The impact of multimorbidity is often significantly greater than expected from the sum of the effects of each condition. The World Health Organization has indicated that healthcare systems must prepare for a change in the focus of clinical care for older people. The World Health Organization (WHO) defines healthcare quality as care that is effective, efficient, integrated, patient centered, equitable and safe. The degree to which healthcare quality can be defined as acceptable is determined by services’ ability to meet the needs of users and adapt to patients’ expectations and perceptions.Method: We took a phenomenological perspective to explore older patients’ subjective experiences and conducted semistructured individual interviews. Eighteen patients (aged from 82 to 100 years) were interviewed twice after discharge from hospital. The interview transcriptions were analyzed thematically.Results: The patients found their meetings with the health service to be complex and demanding. They reported attempting to restore a sense of security and meaning in everyday life, balancing their own needs against external requirements. Five overarching themes emerged from the interviews: hospital stay and the person behind the diagnosis, poor communication and coordination, life after discharge, relationship with their next of kin, and organizational and systemic determinants.Conclusion: According to the WHO, to deliver quality healthcare, services must include all six of the dimensions listed above. Our findings show that they do not. Healthcare focused on measurable values and biomedical inquiries. Few opportunities for participation, scant information and suboptimal care coordination left the patients with a feeling of being in limbo, where they struggled to find balance in their everyday life. Further work must be done to ensure that integrated services are provided without a financial burden, centered on the needs and rights of older people.


Author(s):  
Hamed Salem S. Albalwei ◽  
Nazim Faisal Hamed Ahmed

Patients in need of healthcare expect high quality personalized care, which is also the primary goal of service providers. The main objective of our study was to synthesize the current evidence on the quality of patient care in hospital management. Methods: MEDLINE, Embase, CINAHL, PsycInfo, and ASSIA were searched from 2000 to April 2021, and reference lists of included studies were searched. The included studies describe the current evidence for the quality of patient care in hospital management. No software was used to analyze the data. The data are extracted on the basis of a specific form containing (Name of the author, year of publication, country, method and results). Results and Conclusions: Communicating a better understanding of health care quality is an important preliminary step towards health care quality research and initiatives. Without clear meaning, quality improvement can be sporadic or ineffective. Competent authorities should consider shaping the curriculum to provide training for future professionals to increase patient satisfaction. Improving the quality of health services requires strong leadership from national governments, targeted local support and action at the health facility level. At all levels, there is a need to engage and empower the communities served by the health system. Improving the quality of health services requires special attention to the creation and learning of knowledge. Lessons on the delivery of quality care should be systematically documented, documented and shared within and across countries. 


2018 ◽  
Vol 27 (01) ◽  
pp. 156-162 ◽  
Author(s):  
Harshana Liyanage ◽  
Siaw-Teng Liaw ◽  
Emmanouela Konstantara ◽  
Freda Mold ◽  
Richard Schreiber ◽  
...  

Background: Patients' access to their computerised medical records (CMRs) is a legal right in many countries. However, little is reported about the benefit-risk associated with patients' online access to their CMRs. Objective: To conduct a consensus exercise to assess the impact of patients' online access to their CMRs on the quality of care as defined in six domains by the Institute of Medicine (IoM), now the National Academy of Medicine (NAM). Method: A five-round Delphi study was conducted. Round One explored experts' (n = 37) viewpoints on providing patients with access to their CMRs. Round Two rated the appropriateness of statements arising from Round One (n = 16). The third round was an online panel discussion of findings (n = 13) with the members of both the International Medical Informatics Association and the European Federation of Medical Informatics Primary Health Care Informatics Working Groups. Two additional rounds, a survey of the revised consensus statements and an online workshop, were carried out to further refine consensus statements. Results: Thirty-seven responses from Round One were used as a basis to initially develop 15 statements which were categorised using IoM's domains of care quality. The experts agreed that providing patients online access to their CMRs for bookings, results, and prescriptions increased efficiency and improved the quality of medical records. Experts also anticipated that patients would proactively use their online access to share data with different health care providers, including emergencies. However, experts differed on whether access to limited or summary data was more useful to patients than accessing their complete records. They thought online access would change recording practice, but they were unclear about the benefit-risk of high and onerous levels of security. The 5-round process, finally, produced 16 consensus statements. Conclusion: Patients' online access to their CMRs should be part of all CMR systems. It improves the process of health care, but further evidence is required about outcomes. Online access improves efficiency of bookings and other services. However, there is scope to improve many of the processes of care it purports to support, particularly the provision of a more effective interface and the protection of the vulnerable.


2019 ◽  
Vol 66 (1) ◽  
pp. 36-42
Author(s):  
Svetlana Jovanović ◽  
Maja Milošević ◽  
Irena Aleksić-Hajduković ◽  
Jelena Mandić

Summary Health care has witnessed considerable progresses toward quality improvement over the past two decades. More precisely, there have been global efforts aimed to improve this aspect of health care along with experts and decision-makers reaching the consensus that quality is one of the most significant dimensions and features of health system. Quality health care implies highly efficient resource use in order to meet patient’s needs in terms of prevention and treatment. Quality health care is provided in a safe way while meeting patients’ expectations and avoiding unnecessary losses. The mission of continuous improvement in quality of care is to achieve safe and reliable health care through mutual efforts of all the key supporters of health system to protect patients’ interests. A systematic approach to measuring the process of care through quality indicators (QIs) poses the greatest challenge to continuous quality improvement in health care. Quality indicators are quantitative indicators used for monitoring and evaluating quality of patient care and treatment, continuous professional development (CPD), maintaining waiting lists, patients and staff satisfaction, and patient safety.


Author(s):  
Constantin Etco ◽  

One of the priorities of the health care system in Moldova is the medical services’ quality improvement. Th is article presents various defi nitions for health care quality and the principles connected with quality improvement. An important part in this article is allocated to the structure and main principles of total quality management in the health care system. Th is part reveals the problems of the commissions that are studying the quality of medical services in healthcare establishments.


Author(s):  
Jayita Poduval

The impact of medical errors on the delivery of health care is massive, and it significantly reduces health care quality. They could be largely attributed to system failures and not human weakness. Therefore improving health care quality and ensuring quality control in health care would mean making systems function in a better manner. In order to achieve this all sections of society as well as industry must be involved. Reporting of medical error needs to be encouraged and this may be ensured if health care professionals as well as administrators and health consumers come forward without fear of being blamed. To get to the root of the problem- literally and metaphorically- a root cause analysis and audit must be carried out whenever feasible. Persons outside the medical care establishment also need to work with medical service providers to set standards of performance, competence and excellence.


Sign in / Sign up

Export Citation Format

Share Document