Respect and communication more important than waiting time

Respect and communication are weighed most heavily in patient’s overall assessment of care. Structure aspects, such as waiting times, also contribute to the overall assessment. Managers and professionals in health care should focus on improving these aspects if they aim to increase the overall judgement of care given by patients. These findings were recently published by the NIVEL and the Centre for Consumer Experience in Health Care in the journal BMJ Quality & Safety.

Many western countries increasingly allow for competition in their health care systems and also try to enhance the position and role of patients. Patients are expected to behave as consumers who make rational choices for the best possible care. To support the role of patients, information on the quality of care for different providers is considered essential. Typically, quality of care is assessed by retrieving data from the patient records, but also by measuring patient experiences using validated questionnaires. Patient experience surveys contain many items on numerous health care aspects. Broadly, these items can be divided in items that measure structure, process or outcome aspects. 

A patient’s overall judgement of quality of care appears most related to communication and information, followed by waiting times and continuity of care. The experienced result or outcome of the health care process seems of a lesser importance. This may be due to the fact that it is difficult for patients to judge whether other types of care may have resulted in better outcomes. In addition, patients may assume that differences in outcome are rather small.

Respect, dignity and being listened to
NIVEL-head of department Jany Rademakers: “We looked at different patient groups and studied which quality aspects were most reflected by a patient’s overall assessment of quality of care. Surprisingly, differences between patient groups were negligible. Experiences regarding communication were most strongly related to the overall assessment for all patient groups. Communication was measured as the extent to which providers treat patients with respect en dignity, listen attentively, provide the opportunity to ask questions and give understandable information. Accordingly, these aspects deserve careful consideration for health care providers that aim to improve their quality of care.”

The paper reports data from five disease-specific patient experience surveys (Consumer Quality Index surveys). Data were analyzed from patients who suffer from varicose veins, rheumatoid arthritis or spinal disc herniation and patients who underwent a hip- or knee surgery or a cataract surgery.

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