Healthcare quality through the eyes of bloggers: content analysis of non-solicited narratives about patient experiences with healthcare (Preprint)

2021 ◽  
Author(s):  
Mátyás Osváth ◽  
Orsolya Varga ◽  
Karolina Kósa
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
Health Care Quality ◽  
Qualitative Content Analysis ◽  
Tertiary Care ◽  
Healthcare Quality ◽  
Patient Experiences ◽  
Care Quality ◽  
Patient Reports ◽  
Patient Narratives

BACKGROUND Patient experiences constitute an independent dimension of health care quality that can be solicited by structured surveys or at dedicated online platforms. Unsolicited spontaneous patient narratives are much less used but potentially valuable means for gauging patient experiences. OBJECTIVE Our aim was to explore patient experiences in spontaneous patient blogs submitted during one decade to an online health forum. METHODS 1662 non-solicited individual blogs on patient experiences posted between 2009 and 2018 on a Hungarian internet forum were randomly sampled. 20% (n=346) of the blogs were used for qualitative content analysis. A coding framework was constructed based on previous research and taxonomies to analyse content, including specific experiences or episodes. Major categories and subcategories were constructed within the three major dimensions (structure, process, outcome) of Donabedian’s framework for health care quality. RESULTS Majority of blogs described a specific experience (94.2%) in healthcare; almost 40% occurred in tertiary care; 29.5% of the blogs even identified a specific hospital or department. 55.2% of the bloggers were patients themselves, and the majority (92.7%) were dissatisfied with the reported experience. Issues were most frequently related to physicians (65.2%). In terms of Donabedian’s dimensions, problems with human resources dominated “Structure” (74.1%) such as not enough or incompetent staff. Waiting time and access to care (69.19%) comprised the most frequent complaints of material resources within “Structure”. Within “Process”, episodes related to examination (42.86%) accounted for most of the complaints. Outcomes were identified in 60% of the blogs, and deterioration, complication, readmission, or death was reported in 62% of these episodes. CONCLUSIONS Donabedian’s model of healthcare quality was appropriate for the categorization of patient experiences. Regular monitoring of spontaneous patient reports is recommended to utilize them for healthcare quality improvement especially if reports provide specific details.

scholarly journals Use of online knowledge base in primary health care and correlation to health care quality: an observational study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Christian Gerdesköld ◽  
Eva Toth-Pal ◽  
Inger Wårdh ◽  
Gunnar H. Nilsson ◽  
Anna Nager
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Knowledge Base ◽  
Health Care Quality ◽  
Knowledge Bases ◽  
Patient Experiences ◽  
Outcome Data ◽  
Care Quality ◽  
Evidence Based ◽  
Primary Health

Abstract Background Evidence-based information available at the point of care improves patient care outcomes. Online knowledge bases can increase the application of evidence-based medicine and influence patient outcome data which may be captured in quality registries. The aim of this study was to explore the effect of use of an online knowledge base on patient experiences and health care quality. Methods The study was conducted as a retrospective, observational study of 24 primary health care centers in Sweden exploring their use of an online knowledge base. Frequency of use was compared to patient outcomes in two national quality registries. A socio-economic Care Need Index was applied to assess whether the burden of care influenced the results from those quality registries. Non-parametric statistical methods and linear regression were used. Results Frequency of knowledge base use showed two groups: frequent and non-frequent users, with a significant use difference between the groups (p < 0.001). Outcome data showed significant higher values for all seven National Primary Care Patient Survey dimensions in the frequent compared to the non-frequent knowledge base users (p < 0.001), whereas 10 out of 11 parameters in the National Diabetes Register showed no differences between the groups (p > 0.05). Adjusting for Care Need Index had almost no effect on the outcomes for the groups. Conclusions Frequent users of a national online knowledge base received higher ratings on patient experiences, but figures on health care quality in diabetes showed near to no correlation. The findings indicate that some effects may be attributed to the use of knowledge bases and requires a controlled evaluation.

scholarly journals Electronic medical record in cardiology: a 10-year Italian experience

2015 ◽  
Vol 61 (4) ◽  
pp. 317-323
Author(s):  
Clara Carpeggiani ◽  
Alberto Macerata ◽  
Maria Aurora Morales
Keyword(s):  
Health Care ◽  
Medical Record ◽  
Electronic Medical Record ◽  
System Integration ◽  
Health Care Quality ◽  
Care Center ◽  
Health Care Organization ◽  
Tertiary Care ◽  
Care Quality ◽  
Care Organization

SummaryObjectives:the aim of this study was to report a ten years experience in the electronic medical record (EMR) use. An estimated 80% of healthcare transactions are still paper-based.Methods:an EMR system was built at the end of 1998 in an Italian tertiary care center to achieve total integration among different human and instrumental sources, eliminating paper-based medical records. Physicians and nurses who used EMR system reported their opinions. In particular the hospital activity supported electronically, regarding 4,911 adult patients hospitalized in the 2004- 2008 period, was examined.Results:the final EMR product integrated multimedia document (text, images, signals). EMR presented for the most part advantages and was well adopted by the personnel. Appropriateness evaluation was also possible for some procedures. Some disadvantages were encountered, such as start-up costs, long time required to learn how to use the tool, little to no standardization between systems and the EMR technology.Conclusion:the EMR is a strategic goal for clinical system integration to allow a better health care quality. The advantages of the EMR overcome the disadvantages, yielding a positive return on investment to health care organization.

scholarly journals POS1479-HPR PATIENTS’ PERCEPTIONS OF PERSON-CENTRED CARE IN EARLY RA: A QUALITATIVE STUDY

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 1024.2-1024
Author(s):  
E. Landgren ◽  
A. Bremander ◽  
E. Lindqvist ◽  
M. Nylander ◽  
I. Larsson
Keyword(s):  
Health Care ◽  
Qualitative Study ◽  
Health Care Quality ◽  
Professional Competence ◽  
Qualitative Content Analysis ◽  
Care Quality ◽  
Theory And Practice ◽  
Disease Course ◽  
Care Environment ◽  
Early Ra

Background:Data on patients’ experience can identify strengths and weaknesses with given care, why a person-centred care will improve health care quality. In rheumatology care, most research on patient preferences for and experiences of RA care is performed in patients with established RA and less often in patients with early RA. In the early course of RA patients often struggle to manage their new life situation with a chronic disease and its treatment. Expectations and experiences of health care may change over time why it is important to understand how newly diagnosed patients perceive person-centred care.Objectives:To explore patients’ perceptions of person-centred care early in the RA disease course within the framework of person-centred care.Methods:In this qualitative study 31 patients with early RA from four rheumatology specialist outpatient clinics were interviewed. An abductive qualitative content analysis was conducted based on the framework of McCormack and McCance (2006, 2016). The four constructs; prerequisites, care environment, person-centred processes, and person-centred outcomes constituted the four categories in the deductive part of the study. An inductive analysis revealed eleven sub-categories exploring the content of person-centred care for patients with early RA.Results:For patients with early RA person-centred care was described as; 1. Prerequisites were to be treated with respect, to meet dedicated healthcare professionals, and to meet professional competence. 2. The care environment was to have access to a multidisciplinary team, to have access to health care, and a supportive organization. 3. Person-centred processes were to be listened to, to be supported, and to be involved in decision-making. 4. The person-centred outcomes were to be satisfied with received health care and to achieve optimal health.Conclusion:A true person-centred care is important to patients early in the RA disease course, supporting the relevance to implement person-centred approach at all stages in the health care system. This study contributes to information about how to further develop person-centredness in rheumatology care also early in the disease course.References:[1]McCormack, B., & McCance, T. V. (2006). Development of a framework for person-centred nursing. J Adv Nurs, 56(5), 472-479. doi:10.1111/j.1365-2648.2006.04042.x[2]McCormack, B., & McCance, T. V. (2016). Person-centred practice in nursing and health care: theory and practice (2nd edition ed.): John Wiley & Sons.Disclosure of Interests:None declared

scholarly journals Use of online knowledge base in primary health care and correlation to health care quality: An observational study

2020 ◽  
Author(s):  
Christian Gerdeskold ◽  
Eva Toth-Pal ◽  
Inger Wårdh ◽  
Gunnar H. Nilsson ◽  
Anna Nager
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Knowledge Base ◽  
Health Care Quality ◽  
Knowledge Bases ◽  
Patient Experiences ◽  
Outcome Data ◽  
Care Quality ◽  
Evidence Based ◽  
Primary Health

Abstract BackgroundEvidence-based information available at the point of care improves patient care outcomes. Online knowledge bases can increase the application of evidence-based medicine and influence patient outcome data which may be captured in quality registries. The aim of this study was to explore the effect of use of an online knowledge base on patient experiences and health care quality.MethodsThe study was conducted as a retrospective, observational study of 24 primary health care centers in Sweden exploring their use of an online knowledge base. Frequency of use was compared to patient outcomes in two national quality registries. A socio-economic Care Need Index was applied to assess whether the burden of care influenced the results from those quality registries. Non-parametric statistical methods and linear regression were used.ResultsFrequency of knowledge base use showed two groups: frequent and non-frequent users, with a significant use difference between the groups (p<.001). Outcome data showed significant higher values for all seven National Primary Care Patient Survey dimensions in the frequent compared to the non-frequent knowledge base users (p<.001), whereas 10 out of 11 parameters in the National Diabetes Register showed no differences between the groups (p>.05). Adjusting for Care Need Index had almost no effect on the outcomes for the groups.ConclusionsFrequent users of a national online knowledge base received higher ratings on patient experiences, but figures on health care quality in diabetes showed near to no correlation. The findings indicate that some effects may be attributed to the use of knowledge bases and requires a controlled evaluation.

scholarly journals Impact of macro-socioeconomic determinants on sustainable perinatal health care in Portugal: a qualitative study on the opinion of healthcare professionals and experts

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julia Nadine Doetsch ◽  
Sandra C. S. Marques ◽  
Thomas Krafft ◽  
Henrique Barros
Keyword(s):  
Health Care ◽  
Health Care Quality ◽  
Healthcare Professionals ◽  
Healthcare Quality ◽  
Care Quality ◽  
Perinatal Health ◽  
Vlbw Infants ◽  
Socioeconomic Determinants ◽  
Perinatal Health Care ◽  
The Impact

Abstract Background The WHO identified the importance of macro-socioeconomic determinants and political context as interlinked key factors affecting healthcare quality and health equity. As a response to the recent economic and financial crisis, Portugal approved in 2011 the Economic Adjustment Programme (EAP) to obtain financial assistance from the Troika in order to reduce public debt. This study aims to analyse the impact of the economic crisis and the EAP on perinatal healthcare quality for very preterm (VPT) and/or very low birth weight (VLBW) infants, as perceived by healthcare professionals and experts, within the health administrative regions of the two major metropolitan areas in Portugal. Methods A qualitative approach was applied to receive an in-depth understanding and accomplish perspective variability. A purposive sampling technique was used. Semi-structured interviews were conducted with twenty-one healthcare professionals and experts between October 2018–July 2019. Inductive thematic analysis was performed which encompassed a five-step categorization procedure. Data analysis was undertaken by utilizing Nvivo2011 software. Evolved themes were then associated with WHO’s Quality Standards on Maternal and New-born Care. A framework on the impact of macro-socioeconomic determinants on perinatal health care quality was developed. Results Although participants did not perceive the quality of perinatal care had deteriorated, the analysis of their accounts on work experience revealed that it was indeed adversely modified in all WHO Quality Standards. Health care provision was perceived as detrimental in five main areas: 1) Availability of human resources; 2) Functional referral systems; 3) Competent and motivated human resources; 4) Emotional support; and 5) Essential physical resources available. Policy reforms by the EAP resulted in reduced timeliness of care, increased waiting times, cuts in sequence and duration of consultations, and deficiencies in follow-up care for VPT/VLBW infants and their mothers. The EAP directly influenced working environment of healthcare professionals by causing stress, burnout, work absence, and brain drain. Conclusion An interrelation between macro-socioeconomic determinants and perinatal health care quality was disclosed. The economic crisis and EAP have adversely modified equitable perinatal health care quality for VPT/VLBW infants and their mothers. Our findings underlined the negative impact of austerity policies on vulnerable populations.

scholarly journals The exploration of use of an online knowledge base and effect on patient experiences and health care quality: An observational study in primary health care

2020 ◽  
Author(s):  
Christian Gerdeskold ◽  
Eva Toth-Pal ◽  
Inger Wårdh ◽  
Gunnar H. Nilsson ◽  
Anna Nager
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Knowledge Base ◽  
Health Care Quality ◽  
Knowledge Bases ◽  
Patient Experiences ◽  
Outcome Data ◽  
Care Quality ◽  
Evidence Based ◽  
Primary Health

Abstract Background: Evidence-based information available at the point of care improves patient care outcomes. Online knowledge bases can increase the application of evidence-based medicine and influence patient outcome data which may be captured in quality registries. The aim of this study was to explore the effect of use of an online knowledge base on patient experiences and health care quality.Methods: The study was conducted as a retrospective, observational study of 24 primary health care centers in Sweden exploring their use of an online knowledge base. Frequency of use was compared to patient outcomes in two national quality registries. A socio-economic care need index was applied to assess whether the burden of care influenced the results from those quality registries. Non-parametric statistical methods and linear regression were used.Results: Frequency of knowledge base use showed two groups: frequent and non-frequent users, with a significant use difference between the groups (p<.001). Outcome data showed significant higher values for all seven National Primary Care Patient Survey dimensions in the frequent compared to the non-frequent knowledge base users (p<.001), whereas 10 out of 11 parameters in the National Diabetes Register showed no differences between the groups (p>.05). Adjusting for care need index had almost no effect on the outcomes for the groups.Conclusions: Frequent users of a national online knowledge base received higher ratings on patient experiences, but figures on health care quality in diabetes showed near to no correlation. The findings indicate that some effects may be attributed to the use of knowledge bases and requires a controlled evaluation.

scholarly journals An International Comparison of Web-based Reporting About Health Care Quality: Content Analysis

2010 ◽  
Vol 12 (2) ◽  
pp. e8 ◽  
Author(s):  
Olga C Damman ◽  
Ylva KA van den Hengel ◽  
A Jeanne M van Loon ◽  
Jany Rademakers
Keyword(s):  
Health Care ◽  
Content Analysis ◽  
International Comparison ◽  
Health Care Quality ◽  
Care Quality ◽  
Web Based

scholarly journals Use of online knowledge base in primary health care and correlation to health care quality: An observational study

2020 ◽  
Author(s):  
Christian Gerdeskold ◽  
Eva Toth-Pal ◽  
Inger Wårdh ◽  
Gunnar H. Nilsson ◽  
Anna Nager
Keyword(s):  
Health Care ◽  
Primary Health Care ◽  
Knowledge Base ◽  
Health Care Quality ◽  
Knowledge Bases ◽  
Patient Experiences ◽  
Outcome Data ◽  
Care Quality ◽  
Evidence Based ◽  
Primary Health

Abstract BackgroundEvidence-based information available at the point of care improves patient care outcomes. Online knowledge bases can increase the application of evidence-based medicine and influence patient outcome data which may be captured in quality registries. The aim of this study was to explore the effect of use of an online knowledge base on patient experiences and health care quality.MethodsThe study was conducted as a retrospective, observational study of 24 primary health care centers in Sweden exploring their use of an online knowledge base. Frequency of use was compared to patient outcomes in two national quality registries. A socio-economic Care Need Index was applied to assess whether the burden of care influenced the results from those quality registries. Non-parametric statistical methods and linear regression were used.ResultsFrequency of knowledge base use showed two groups: frequent and non-frequent users, with a significant use difference between the groups (p<.001). Outcome data showed significant higher values for all seven National Primary Care Patient Survey dimensions in the frequent compared to the non-frequent knowledge base users (p<.001), whereas 10 out of 11 parameters in the National Diabetes Register showed no differences between the groups (p>.05). Adjusting for Care Need Index had almost no effect on the outcomes for the groups.ConclusionsFrequent users of a national online knowledge base received higher ratings on patient experiences, but figures on health care quality in diabetes showed near to no correlation. The findings indicate that some effects may be attributed to the use of knowledge bases and requires a controlled evaluation.

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