Backgroung In the field of health care liability, the concepts of clinical outcome expectation and patient satisfaction (both as far as the patient is concerned and as far as the physician is concerned) are of primary importance, as they condition the risk of a given health care relationship becoming the subsequent subject of a legal dispute. In particular, the risk of medico-legal litigation increases significantly when the patient feels dissatisfied with the health care received (regarding both treatment and care) and/or when the outcome expectations accrued by the patient diverge appreciably from those accrued by the physician. Aim of the study The research is designed as a prospective multicenter observational pilot study, and its goal in the short term is to provide an overview of patient expectations and satisfaction in a given department, as well as to analyze the characteristics of the correlation between the two components. In the long term, however, in a timeframe to be determined, the data collected and analyzed will be compared with the claims regarding this Operating Unit to define the importance of the components of patient expectation, satisfaction and safety in the emergence of medical-legal litigation, with particular reference to the discordance of expectations between inpatient and physician. Materials and methods The survey involves the administration of two questionnaires, respectively for the patient and for the physician in charge of the patient within the department, consisting of a section dedicated to entry into the OU and one dedicated to discharge, completed in the correct moments. At discharge, an additional questionnaire is administered to the patient alone to survey his or her satisfaction with the hospitalization. Participation 4 is voluntary and data are treated anonymously. Results are expressed in absolute frequencies and percentages. Results Fifty patients were recruited from Clinica Medica 3 during the period between October 2022 and January 2023 (42% were women and 58% were men). Several parameters contributing to the formulation of hospitalization expectancy and the establishment of patient satisfaction were investigated. In summary, 82% of the inpatients described their experience in the ward as positive overall, and similarly, the OU physicians felt that the patient had spent the hospital stay adequately in 84% of cases. In addition, 90 percent of patients rated their mood at discharge as “satisfied” or higher. Conclusions The percentage of satisfied patients appears fairly high, as does the proportion of patients who say they had a positive hospitalization experience. In the department, particular importance is attached to communication between physician and patient regarding two main topics, namely expectations regarding the progress of hospitalization and the clinical outcome achieved, both of which are the subject of dialogue between the two figures in at least three-quarters of cases. Analyzing the (albeit minority) share of patients who were not satisfied at the end of hospitalization, two main critical issues are found: the worsening of physical and/or psychological conditions during hospitalization and the description of the hospitalization experience defined as not positive overall. In the future, at a time to be determined, claims regarding the period of data collection that are directed toward the department in which the study took place will be analyzed to reveal any correlations with specific determinants of expectations and satisfaction that may have contributed to the origin of the litigation.
Presupposti dello studio In ambito di responsabilità sanitaria, i concetti di aspettativa di risultato clinico e di soddisfazione del paziente (sia per quanto riguarda quest’ultimo, sia per quanto riguarda il medico) sono di importanza primaria, poiché condizionano il rischio che una determinata relazione sanitaria diventi successivo argomento di una disputa giuridica. In particolare, il rischio di contenzioso medico-legale aumenta sensibilmente quando il paziente si sente insoddisfatto della prestazione sanitaria ricevuta (percepita come integrazione sia della cura che dell’assistenza) e/o quando le aspettative di risultato maturate dal paziente divergono apprezzabilmente da quelle maturate dal medico. Obiettivi dello studio La ricerca è stata disegnata come uno studio pilota multicentrico osservazionale prospettico e il suo obiettivo nel breve termine è quello di fornire una panoramica delle aspettative e della soddisfazione dei pazienti di un determinato reparto, oltre ad analizzare le caratteristiche della correlazione tra le due componenti. Nel lungo termine, invece, in un tempo da definire, i dati raccolti e analizzati verranno confrontati con le richieste di risarcimento danni riguardanti tale Unità Operativa per definire l’importanza delle componenti di aspettativa, soddisfazione e sicurezza del paziente nella nascita del contenzioso medico legale, con particolare riferimento alle discordanze delle aspettative tra soggetto ricoverato e medico. Materiali e metodi L’indagine prevede la somministrazione di due questionari, rispettivamente per il paziente e per il medico che lo ha in carico all’interno del reparto, costituiti da una sezione dedicata all’ingresso nell’UO e una dedicata alla 2 dimissione, compilati nei dati momenti. Alla dimissione viene somministrato, al solo paziente, un ulteriore questionario per la rilevazione della sua soddisfazione in merito al ricovero. La partecipazione è volontaria e i dati sono trattati in forma anonima. I risultati vengono espressi in frequenze assolute e in percentuale. Risultati Sono stati reclutati 50 pazienti dalla Clinica Medica 3 nel periodo tra ottobre 2022 e gennaio 2023, di cui 42% donne e 58% uomini. Sono stati indagati diversi parametri contribuenti alla formulazione dell’aspettativa di ricovero e alla costituzione della soddisfazione del paziente. In sintesi, l’82% dei soggetti ricoverati ha definito complessivamente positiva l’esperienza nel reparto e, similmente, i medici dell’UO hanno avuto l’impressione che l’assistito avesse trascorso la degenza in maniera adeguata nell’84% dei casi. Il 90% dei pazienti, inoltre, ha classificato il proprio stato d’animo alla dimissione come “soddisfatto” o superiore. Conclusioni La percentuale di pazienti soddisfatta appare discretamente elevata, così come la quota di pazienti che dichiara di aver vissuto un’esperienza positiva di ricovero. Nell’UO viene attribuita particolare importanza alla comunicazione tra medico e paziente riguardo due principali argomenti, cioè le aspettative in merito all’andamento del ricovero e il risultato clinico conseguito, entrambi oggetto di dialogo tra le due figure in almeno tre quarti dei casi. Analizzando la quota (seppur minoritaria) di pazienti che non si sono dichiarati soddisfatti al termine del ricovero, si riscontrano due principali criticità: il peggioramento delle condizioni fisiche e/o psicologiche in corso di degenza e la descrizione dell’esperienza di ricovero definita complessivamente non positiva. In futuro, in un tempo da definire, verranno analizzate le richieste di risarcimento, relativamente al periodo di raccolta dati, rivolte verso al reparto in cui si è svolto lo studio, per evidenziare eventuali correlazioni con specifici determinanti di aspettative e soddisfazione che possono aver contribuito a originare il contenzioso.
Aspettative e soddisfazione del paziente ospedaliero: studio multicentrico
FABRIS, PIETRO
2022/2023
Abstract
Backgroung In the field of health care liability, the concepts of clinical outcome expectation and patient satisfaction (both as far as the patient is concerned and as far as the physician is concerned) are of primary importance, as they condition the risk of a given health care relationship becoming the subsequent subject of a legal dispute. In particular, the risk of medico-legal litigation increases significantly when the patient feels dissatisfied with the health care received (regarding both treatment and care) and/or when the outcome expectations accrued by the patient diverge appreciably from those accrued by the physician. Aim of the study The research is designed as a prospective multicenter observational pilot study, and its goal in the short term is to provide an overview of patient expectations and satisfaction in a given department, as well as to analyze the characteristics of the correlation between the two components. In the long term, however, in a timeframe to be determined, the data collected and analyzed will be compared with the claims regarding this Operating Unit to define the importance of the components of patient expectation, satisfaction and safety in the emergence of medical-legal litigation, with particular reference to the discordance of expectations between inpatient and physician. Materials and methods The survey involves the administration of two questionnaires, respectively for the patient and for the physician in charge of the patient within the department, consisting of a section dedicated to entry into the OU and one dedicated to discharge, completed in the correct moments. At discharge, an additional questionnaire is administered to the patient alone to survey his or her satisfaction with the hospitalization. Participation 4 is voluntary and data are treated anonymously. Results are expressed in absolute frequencies and percentages. Results Fifty patients were recruited from Clinica Medica 3 during the period between October 2022 and January 2023 (42% were women and 58% were men). Several parameters contributing to the formulation of hospitalization expectancy and the establishment of patient satisfaction were investigated. In summary, 82% of the inpatients described their experience in the ward as positive overall, and similarly, the OU physicians felt that the patient had spent the hospital stay adequately in 84% of cases. In addition, 90 percent of patients rated their mood at discharge as “satisfied” or higher. Conclusions The percentage of satisfied patients appears fairly high, as does the proportion of patients who say they had a positive hospitalization experience. In the department, particular importance is attached to communication between physician and patient regarding two main topics, namely expectations regarding the progress of hospitalization and the clinical outcome achieved, both of which are the subject of dialogue between the two figures in at least three-quarters of cases. Analyzing the (albeit minority) share of patients who were not satisfied at the end of hospitalization, two main critical issues are found: the worsening of physical and/or psychological conditions during hospitalization and the description of the hospitalization experience defined as not positive overall. In the future, at a time to be determined, claims regarding the period of data collection that are directed toward the department in which the study took place will be analyzed to reveal any correlations with specific determinants of expectations and satisfaction that may have contributed to the origin of the litigation.File | Dimensione | Formato | |
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https://hdl.handle.net/20.500.12608/47409