Hospitalization from the patient perspective: a data linkage study of adults in Australia

Int J Qual Health Care. 2018 Jun 1;30(5):358-365. doi: 10.1093/intqhc/mzy024.

Abstract

Objective: Evidence of the patient experience of hospitalization is an essential component of health policy and service improvement but studies often lack a representative population sample or do not examine the influence of patient and hospital characteristics on experiences. We address these gaps by investigating the experiences of a large cohort of recently hospitalized patients aged 45 years and over in New South Wales (NSW), Australia who were identified using data linkage.

Design: Cross-sectional survey.

Setting: Hospitals in NSW, Australia.

Participants: The Picker Patient Experience Survey (PPE-15) was administered to a random sample of 20 000 patients hospitalized between January and June 2014.

Main outcome measure: Multivariable negative binomial regression was used to investigate factors associated with a higher PPE-15 score.

Results: There was a 40% response rate (7661 completed surveys received). Respondents often reported a positive experience of being treated with dignity and respect, yet almost 40% wanted to be more involved in decisions about their care. Some respondents identified other problematic aspects of care such as receiving conflicting information from different care providers (18%) and feeling that doctors spoke in front of them as if they were not there (14%). Having an unplanned admission or having an adverse event were both very strongly associated with a poorer patient experience (P < 0.001). No other factors were found to be associated.

Conclusions: Patient involvement in decision-making about care was highlighted as an important area for improvement. Further work is needed to address the challenges experienced by patients, carers and health professionals in achieving a genuine partnership model.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Attitude of Health Personnel*
  • Cross-Sectional Studies
  • Decision Making
  • Female
  • Hospitalization / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • New South Wales
  • Patient Harm / psychology
  • Patient Participation / psychology
  • Patient Satisfaction / statistics & numerical data*
  • Surveys and Questionnaires