Hospital quality reports in Germany: patient and physician opinion of the reported quality indicators

<p>Abstract</p> <p>Background</p> <p>Starting in 2005, Germany's health law required hospital quality reports to be published every two years by all acute care hospitals. The reports were intended to help patients and physicians make informed choices of hospitals. However, while establishing the quality indicators that form the content of the reports, the information needs of the target groups were not explicitly taken into account. Therefore, the aim of our study was to determine patient and physician opinion of the relevance of the reported quality indicators for choosing or referring to a hospital.</p> <p>Methods</p> <p>Convenience samples of 50 patients and 50 physicians were asked to rate the understandability (patients), suitability (physicians) and relevance (both groups) of a set of 29 quality indicators. The set was drawn from the reports (24 indicators) and supplemented by five indicators commonly used in hospital quality reports. We analysed the differences in patient and physician ratings of relevance of all indicators by applying descriptive statistics, t-tests and Wilcoxon tests.</p> <p>Results</p> <p>Only three indicators were considered not understandable by the interviewed patients and unsuitable by the interviewed physicians. The patients rated 19 indicators as highly or very relevant, whereas the physicians chose 15 indicators. The most relevant indicator for the patients was "qualification of doctors", and for the physicians "volume of specified surgical procedures". Patient and physician rankings of individual indicators differed for 25 indicators. However, three groups of indicators could be differentiated, in which the relevance ratings of patients and physicians differed only within the groups. Four of the five indicators that were added to the existing set of reported indicators ranked in the first or second group ("kindness of staff", "patient satisfaction", "recommendation", and "distance to place of living").</p> <p>Conclusion</p> <p>Most of the content of Germany's hospital quality reports seems to be useful for patients and physicians and influence their choice of hospitals. However, the target groups revealed that approximately one third of the indicators (mostly hospital structural characteristics), were not useful and hence could have been omitted from the reports. To enhance the usefulness of the reports, indicators on patient experiences should be added.</p

Assessing elderly persons’ health-related quality of life with the WHOQOL-BREF questionnaire

In the last years the evaluation of subjective, health-related quality of life (HRQOL) is increasingly integrated as an outcome criterion in the health system. Especially in gerontology there is however still great need for validated instruments assessing HRQOL and comprehensive generic quality of life (QOL), including for example also environmental aspects. To measure generic QOL under the patronage of the World Health Organisation, the WHOQOL Group developed the WHOQOL-BREF, a generic QOL instrument with 26 items, attributed to four subscales (psychological well-being, physical well-being, social relations and environment). First results using the swiss/french version of the WHOQOL-BREF in older swiss french speaking individuals (N = 178, mean age 74 years) are presented. Its psychometric properties were adequate and are comparably to those found in an older german group (N = 354, mean age 73; Matschinger et al. in preparation). For the two samples, the original four-factor structure was not easily reproducible. Nevertheless this structure was kept as in other publications (Leplège et al., 2000; Skevington, Lotfy & O’Connel, 2004). Unlike as in other studies no link was found between socio-demographic variables and QOL. The correlation between the number of health problems and depression on the one hand and QOL on the other hand was negative, as expected. However age moderated the relation between health problems and QOL: in older age, the negative effect of health problems on QOL was less pronounced. © 2005 - IOS Press and the authors. All rights reserved