Healthcare Experience and their Relationship with Demographic, Disease and Healthcare-Related Variables: A Cross-Sectional Survey of Patients with Chronic Diseases Using the IEXPAC Scale
Por:
Orozco-Beltrán D, de Toro J, Galindo MJ, Marín-Jiménez I, Casellas F, Fuster-RuizdeApodaca MJ, García-Vivar ML, Hormigo-Pozo A, Guilabert M, Sánchez-Vega N, Fernández G, Cea-Calvo L
Publicada:
1 jun 2019
Ahead of Print:
15 nov 2018
Resumen:
BackgroundPatient experience is acknowledged as a principal aspect of quality healthcare delivery, and it has implications with regard to outcomes.ObjectivesOur objective was to evaluate the healthcare experience of patients with chronic diseases to identify patient-perceived healthcare gaps and to assess the influence of demographic and healthcare-related variables on patient experiences.MethodsA cross-sectional survey was delivered to adult patients with chronic diseases: diabetes mellitus (DM), human immunodeficiency virus (HIV) infection, inflammatory bowel disease (IBD) or rheumatic diseases. Patient experiences were assessed with the Instrument for Evaluation of the Experience of Chronic Patients (IEXPAC) questionnaire, with possible scores ranging from 0 (worst) to 10 (best experience).ResultsOf the 2474 patients handed the survey, 1618 returned it (response rate 65.4%). Patients identified gaps in healthcare related mainly to access to reliable information and services, interaction with other patients and continuity of healthcare after hospital discharge. The meanstandard deviation (SD) IEXPAC score was 6.0 +/- 1.9 and was higher for patients with HIV (6.6 +/- 1.7) than for those with rheumatic disease (5.5 +/- 2.0), IBD (5.9 +/- 2.0) or DM (5.9 +/- 1.9) (p<0.001). In multivariate models, better overall IEXPAC experience was associated with follow-up by the same physician, follow-up by a nurse, receiving healthcare support from others and treatment with subcutaneous or intravenous drugs. The multivariate model that confirmed patients with HIV or DM had better experience than did those with rheumatic diseases.Conclusions p id=Par5 Through IEXPAC, patients identified aspects for healthcare quality improvements and circumstances associated with better experience, which may permit greater redirection of healthcare toward patient-centered goals while facilitating improvements in social care and long-term healthcare quality.
Filiaciones:
Orozco-Beltrán D:
Clinical Medicine Department, Miguel Hernandez University, San Juan de Alicante, Spain
de Toro J:
Rheumatology Department, A Coruña University Hospital, A Coruña, Spain
Galindo MJ:
Clinic University Hospital, Valencia, Spain
Marín-Jiménez I:
IBD Unit, Gastroenterology Department, Clinical Research Institute Gregorio Marañón (IiSGM), Gregorio Marañón University, Madrid, Spain
Casellas F:
Crohn-Colitis Care Unit, Hospital Universitari Vall d'Hebron, Barcelona, Spain
Fuster-RuizdeApodaca MJ:
SEISIDA (Spanish AIDS Multidisciplinary Society), Madrid, Spain
García-Vivar ML:
Rheumatology Department, Basurto University Hospital, Bilbao, Spain
Hormigo-Pozo A:
San Andres-Torcal Health Care Center, Málaga, Spain
Guilabert M:
Department of Health Psychology, Miguel Hernández University, Elche, Alicante, Spain
Sánchez-Vega N:
Medical Affairs Department, Merck Sharp and Dohme Spain, Madrid, Spain
Fernández G:
Medical Affairs Department, Merck Sharp and Dohme Spain, Madrid, Spain
Cea-Calvo L:
Medical Affairs Department, Merck Sharp and Dohme Spain, Madrid, Spain.
Green Published, hybrid
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