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Exploration of patient evaluations of health care quality in 12 different European countries in relation to health system performance.

Kerssens, J.J., Groenewegen, P.P., Sixma, H.J., Boerma, W.G.W., Eijk, I. van der. Exploration of patient evaluations of health care quality in 12 different European countries in relation to health system performance. European Journal of Public Health: 2003, 13(4 sup) 77. Abstract. 11th Annual Eupha Meeting 'Globalisation and Health in Europe: Harmonising Public Health Practices'. Rome, Italy, 20-22 November 2003.
Background: Large differences between countries exist in the use, costs, quality, accessibility etc. of health services. Also large differences exist between countries in patient evaluations of their health care system. But how do patient evaluations relate to health care performance? Aim: This study’s objective is to gain insight into the similarities and
differences in patient evaluations of quality of health care across 12 European countries and to correlate patient evaluations with WHO health system performance measures (e.g. responsiveness) of these countries. Methods: Patient evaluations were derived from a series of instruments (Quote) designed to measure quality of health care. Various research groups provided a total sample of 5,1333 patients, including material from 12 countries: Belarus, Denmark, Finland, Greece, Ireland, Israel, Italy, Netherlands, Norway, Portugal, UK, and Ukraine. Intra-class correlations of ten Quote-items were calculated to measure differences between countries. The World Health Report 2000 performance measures in the same countries were correlated with mean Quote scores. Results: Intra-class correlation coefficients ranged from low to very high, indicating little variation between countries in some respects (for instance health care providers have a good understanding of patients’ problems in all countries) and a large amount of variation in other respects (for instance regarding the description of full cover for medication, and communication between health care providers). Most of the correlations between mean Quote scores per country and WHO performance measures were positive. The highest correlation (.86) was between the health care provider’s understanding of patient’s problems and WHO responsiveness. Conclusions: Patient evaluations of health care quality reveal large differences across countries and are positively related to WHO performance measures of health care systems. (aut.ref.)