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By ISQua Wednesday. Feb 4, 2015

Patient experiences of inpatient hospital care: a department matter and a hospital matter

for healthcare purchasing by healthcare insurers or health plans, by patients in deciding which healthcare provider to visit, but also by healthcare providers themselves to improve their care. If experiences are measured in a standardized way across healthcare institutions, differences between institutions can be identified. 

It is not always clear, however, which organizational levels are responsible for failure or success; quality information is often too abstract for targeted action. This is especially problematic for large healthcare institutions, such as hospitals, consisting of numerous different healthcare disciplines and departments. By averaging performance scores across the hospital, the poor or high performances of specific departments may be obscured. Arguably, if patient experiences are to be used to their full potential, it is very important to present results at the correct organizational level at which results are most informative. In this paper, we focused on incorporating the department level in measurements of patient experiences in Dutch inpatient hospital care.

We used data from a 2007 national survey on patient experiences of Dutch inpatient hospital care (Consumer Quality Index (CQI) Inpatient Hospital Care). In total, the experiences of 15,171 inpatients from 78 Dutch hospitals were included.Quality indicators were calculated from the patients’ responses to the survey items. 

Our results showed that differences in quality indicator scores were only influenced to a limited extent by either the specific hospital department or the hospital as a whole. At best, 14% of the variance in indicator scores could be explained by the department and the hospital a patient visited. However, adding the department level to the analyses of patient experiences proved statistically worthwhile for a number of quality indicators, and would enable the presentation of more detailed results; at department level instead of hospital level.

Furthermore, the results indicated that there were some differences in patient experiences between specific types of departments across hospitals. Although these differences were small for most quality indicators, some scores were significantly higher in specific department types. For instance, patient experiences of information provided to them at discharge (figure (scores 1-4); Npat 13,304, Ndept 1,002). 

Analyses of quality information on patient experiences of inpatient hospital care should not only take into account the hospital level, but also at the more specific department level. Furthermore, differences in performances of departments or department types should be explored in future research.

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