Corruption, inequality and population perception of healthcare quality in Europe

Background Evaluating the quality of healthcare and patient safety using general population questionnaires is important from research and policy perspective. Using a special wave of the Eurobarometer survey, we analysed the general population’s perception of health care quality and patient safety in a cross-country setting. Methods We used ordered probit, ordinary least squares and probit analysis to estimate the determinants of health care quality, and ordered logit analysis to analyse the likelihood of being harmed by a specific medical procedure. The models used population weights as well as country-clustered standard errors. Results We found robust evidence for the impact of socio-demographic variables on the perception of quality of health care. More specifically, we found a non-linear impact of age on the perception of quality of health care and patient safety, as well as a negative impact of poverty on both perception of quality and patient safety. We also found robust evidence that countries with higher corruption levels were associated with worse perceptions of quality of health care. Finally, we found evidence that income inequality affects patients’ perception vis-à-vis safety, thus feeding into the poverty/health care quality nexus. Conclusions Socio-demographic factors and two macro variables (corruption and income inequality) explain the perception of quality of health care and likelihood of being harmed by adverse events. The results carry significant policy weight and could explain why targeting only the health care sector (without an overall reform of the public sector) could potentially be challenging

Exploring the relationship between personal control and the hospital environment

Aims & Objectives: This paper describes the further development of the substantive theory Optimising Personal Control to Facilitate Emotional Comfort. In previous work, emotional comfort was identified as a therapeutic state that was influenced by several factors, one of which was the hospital environment. This paper focuses on aspects within the hospital environment that patients perceive to influence their feelings of personal control. Background: A relationship between control and health has been discussed in previous literature. There are indications that aspects of the hospital environment can impact on a patient's perception of control. This project explored personal control in relation to the hospital environment from the perspective of patients.Methods: Grounded theory method was used. Data were collected from patients' interviews and field observations and analysed using the constant comparative method. Interviews were tape-recorded and transcribed verbatim. A qualitative data computer program was used to manage the data. Results: The results confirmed the findings of the original study where hospitalised patients were found to experience feelings of reduced personal control. The conditions of level of security, level of knowing and level of personal value were described in terms of their contribution to the patient's feelings of personal control. Conclusions: Specific directions for further research into the development and evaluation of therapeutic hospital environments that promote personal control and the associated emotional comfort are provided. Relevance to clinical practice: This research highlights the importance of considering patients' feelings of personal control during their hospital stay. Several directions for establishment of therapeutic environments within hospitals are provided, but more research in this area is recommended