Wartości przypisywane ciągłości opieki przez pacjentów przewlekle chorych – wyniki badania jakościowego

• Authors: Rudawska Iga

Title variants

EN

Chronic Patients’ Values Associated to Continuity of Care – the Results of Qualitative Study

• Languages of publication: PL

Abstracts

PL

Celem niniejszego artykułu jest identyfikacja doświadczeń pacjentów przewlekłe chorych i wartości przypisywanych przez tych pacjentów ciągłości opieki w polskich podmiotach leczniczych. Autorka odpowiada na dwa główne pytania badawcze: (1) jakie czynniki pacjenci postrzegają jako istotne dla ciągłości opieki?, (2) w jaki sposób można te elementy pogrupować w celu stworzenia modelu oceny jakości opieki nad pacjentem w kontekście ciągłości opieki? Stosując analizę jakościową, przeprowadzono zogniskowany wywiad grupowy z 10 pacjentami przewlekle chorymi. Zebrane odpowiedzi pogrupowano tematycznie w wymiary ciągłości opieki. Na podstawie doświadczeń pacjentów nakreślono model oceny ciągłości opieki. Wyróżniono 8 kategorii centralnych i 36 sub-wymiarów, które umożliwiają całościową ewaluację postrzeganej jakości w opiece nad pacjentem w stanach przewlekłych. Zidentyfikowano następujące wymiary centralne: aktywacja pacjentów, wsparcie przy podejmowaniu decyzji, ciągłość relacyjna, koordynacja działań, komunikacja z pacjentem, rozwiązywania problemów, elastyczność i dostępność oraz orientacja na pacjenta. Praca stanowi wstęp do koncepcyjnego modelu oceny ciągłości opieki. Identyfikuje zarazem newralgiczne punkty braku owej ciągłości.

EN

The aim of this paper is to identify chronic patients’ experiences and values associated to continuity in care in integrated health care settings in Poland. The author answers two major research questions: (1) what variables do patients perceive to be significant in the continuity of care?, (2) how can the isolated elements be grouped in order to establish a model of evaluating patient care quality in the respect of continuity of care? Applying the qualitative study, focus group interview with 10 chronic ill patients has been carried. Collected responses were analysed thematically and grouped into dimensions of continuity of care. A patient-based framework for evaluating continuity of care was developed. 8 central categories and 36 sub-dimensions were constructed, that allow quality of integrated health care to be examined holistically. The following central dimensions of experienced continuity of care were identified: patients’ involvement, decision-making support, cross-boundary continuity, coordination of activities, communication with the patient, problem solving, flexibility and availability, and patient-centeredness. This study develops a patient-based framework for evaluating continuity of care. Is also identifies key transition points with problems of lack of continuity.

Keywords

PL

ciągłość opieki; percepcja pacjentów; opieka w chorobach przewlekłych; wskaźniki jakości; Polska

EN

continuity of care; patient perceptions; chronic care; quality indicators; Poland

• Publisher: Uniwersytet Warszawski. Wydział Nauk Ekonomicznych
• Journal: Problemy Zarządzania
• Year: 2015
• Issue: 2/2015 (53), t. 2
• Pages: 196-215

Contributors

author

Rudawska Iga

• University of Szczecin, Faculty of Economics and Management Institute of Economics Department of Health Economics

References

• Aldana, J.M., Al.-Sabir, A. and Piechulek, H. (2001). Client satisfaction and quality of health care in rural Bangladesch. Bulletin of the WHO. 79(6), 512–515.
• Antunes, V. and Moreira, J.P. (2001). Approaches to developing integrated care in Europe: a systematic literature review. Journal of Management and Marketing in Healthcare, 4(2), 129–132.
• Asch, S. (2006). Who is at greatest risk for receiving poor-quality health care? New England Journal of Medicine, 354(11), 1147–1156.
• Cowie, L., Morgan, M., White, P. and Gulliford, M. (2009). Experience of continuity of care of patients with multiple long-term conditions in England. Journal of Health Services Research & Policy, 14(2), 82.
• Delnoij, D.M., Klazinga N.S. and van der Velden, K. (2003). Building integrated health systems in central and eastern Europe. European Journal of Public Health, 13, 240–245.
• Freeman, G.K., Sheppenrd, S., Robinson, I., Ehrich, K. and Richards, S. (2000). Report of a Scoping Exercise for the National Co-ordinating Centre for NHS Service Delivery and Organization R&D (NCCSDO). London: NHS Publications.
• Freeman, G.K., Olesen, F. and Hjortdahl, P. (2003). Continuity of care: an essential element of modern general practice? Family Practice, 20, 623–627.
• Glaser, B.G. and Strauss, A.L. (2009). Odkrywanie teorii ugruntowanej. Strategie badania jakościowego. Krakow: Zakład Wydawniczy Nomos.
• Gröne, O. and Garcia-Barbero, M. (2001). Integrated care. A position paper of the WHO European office for integrated health care services. International Journal of Integrated Care, 1, 1–21.
• Haggerty, J.L., Reid, R.J., Freeman, G.K., Starfield, B.H., Adair, C.E. and McKendry, R. (2003). Continuity of care: A multidisciplinary review. British Medical Journal, 327, 1219–1221.
• Jakab, A. and Tsouros, D. (2014). Health 2020 – Achieving Health and Development in Today’s Europe. Central European Journal of Public Health, 22(2), 133–138.
• Johnston, R. (1995). The determinant of service quality: satisfiers and dissatisfiers. International Journal of Service Industry Management, 6(5), 63.
• Kodner, D. (2003). Consumer-directed services: lessons and implications for integrated system of care. International Journal of Integrated Care, 3, 5.
• Krueger, R.A. (1994). Focus groups: a practical guide for applied research. London: Sage Publications.
• Linder-Pelz, S. (1982). Toward a theory of patient satisfaction. Social Science & Medicine, 16, 577–582.
• Madhok, R. (2001). Crossing the Quality Chasm: lessons from health care quality improvement efforts in England. Proceedings Baylor University Medical Center, 15(1), 77–83.
• Mur-Veeman, I., Hardy, B., Steenbergen, M. and Wistow, G. (2003). Development of integrated care in England and the Netherlands: managing across public private boundaries. Health Policy. 65: 228.
• Naithani, S., Gulliford, M. and Morgan, M. (2006). Patients’ perceptions and experiences of continuity of care in diabetes. Health Expectations, 9, 119. Organization of Economic Co-operation and Development. Value of money in health spending (2010). Paris: OECD Publishing.
• Pascoe, G.C. (1983). Patient satisfaction in primary health care: a literature review and analysis. Journal of Evaluation and Program Planning, 6, 185-210.
• Raak, A., Mur-Veeman, I., Hardy, B., Steenbergen, M. and Paulus, A. (2003). Integrated care in Europe. Description and comparison of integrated care in six EU countries. Maarssen: Elsevier.
• Rodrigez, C. and Riveres-Pigeon, C.A. (2007). Literature review on integrated perinatal care. International Journal of Integrated Care, 7, 3.
• Schröder-Bäck, P., Clemens, T., Michelsen, K., Schulte in den Bäumen, T., Sørensen, K., Borrett, G. and Brand, H. (2012). Public Health Ethical Perspectives on the Values of the European Commission‘s White Paper „Together for Health“. Central European Journal of Public Health, 20(2), 95–100.
• Stranberg-Larsen, M. and Krasnik, A. (2009). Measurement of integrated healthcare delivery: a systematic review of methods and future. International Journal of Integrated Care, 9, 1–9.
• Uijen, A.A., Schers, H.J., Schellevis, F.G. and Van de Bosch, W.J. (2012). How unique is continuity of care? A review of continuity and related concepts. Family Practice, 29(3), 268.
• Vrijhoef, H.J., Berbee, R., Wagner, E.H. and Steuten, L.M. (2009). Quality of integrated chronic care measured by patient survey: identification, selection and application of most appropriate instruments. Health Expectations, 12, 417–429.
• Wagner, E.H. (2004). Improving Chronic Illness Care, Chronic Care Model. Washington: MacColl Institute for Health Care Innovation.
• Wagner, E.H., Bennet, S.M., Austin, B.T., Greene, S.M., Schaefer, J.K. and Von Korff,
• M. (2005). Finding common ground: patient centeredness and evidence based chronic illness care. Journal of Alternative & Complementary Medicine, 11, 7-15.
• Weinberg, D.B., Gittell, J.H., Lusenhop, R.W., Kautz, C.M. and Wright, J. (2007). Beyond our walls: Impact of patient and provider coordination across the continuum on surgical outcomes. Health Services Research, 42(1), 7–24.
• Zifko-Baliga, G.M. i Krampf, R.F. (1997). Managing perceptions of hospital quality. Marketing Health Services, 17(1): 28–35.

Identifiers

DOI

10.7172/1644-9584.53.12

ISSN

1644-9584