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Identifying Quality Indicators Used by Patients to Choose Secondary Health Care Providers: A Mixed Methods Approach.

King D, Zaman S, Zaman SS, Kahlon GK, Naik A, Jessel AS, Nanavati N, Shah A, Cox B, Darzi A - JMIR Mhealth Uhealth (2015)

Bottom Line: In keeping with many patient-facing platforms, most services currently providing comparative information on different providers do not take account of end-user requirements or the available evidence base.The mean differences between the other three categories hospital statistics, hospital staff, and hospital facilities, were not statistically significant.Staff competence was the most important indicator in the hospital staff category; cleanliness and up-to-date facilities were equally important in hospital facilities; ease of travel to the hospital was found to be most important in hospital access.

View Article: PubMed Central - HTML - PubMed

Affiliation: Imperial College London, London, United Kingdom. dominic.king@imperial.ac.uk.

ABSTRACT

Background: Patients in health systems across the world can now choose between different health care providers. Patients are increasingly using websites and apps to compare the quality of health care services available in order to make a choice of provider. In keeping with many patient-facing platforms, most services currently providing comparative information on different providers do not take account of end-user requirements or the available evidence base.

Objective: To investigate what factors were considered most important when choosing nonemergency secondary health care providers in the United Kingdom with the purpose of translating these insights into a ratings platform delivered through a consumer mHealth app.

Methods: A mixed methods approach was used to identify key indicators incorporating a literature review to identify and categorize existing quality indicators, a questionnaire survey to formulate a ranked list of performance indicators, and focus groups to explore rationales behind the rankings. Findings from qualitative and quantitative methodologies were mapped onto each other under the four categories identified by the literature review.

Results: Quality indicators were divided into four categories. Hospital access was the least important category. The mean differences between the other three categories hospital statistics, hospital staff, and hospital facilities, were not statistically significant. Staff competence was the most important indicator in the hospital staff category; cleanliness and up-to-date facilities were equally important in hospital facilities; ease of travel to the hospital was found to be most important in hospital access. All quality indicators within the hospital statistics category were equally important. Focus groups elaborated that users find it difficult to judge staff competence despite its importance.

Conclusions: A mixed methods approach is presented, which supported a patient-centered development and evaluation of a hospital ratings mobile app. Where possible, mHealth developers should use systematic research methods in order to more closely meet the needs of the end user and add credibility to their platform.

No MeSH data available.


Age spread of questionnaire respondents compared with 2001 United Kingdom census respondents.
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Related In: Results  -  Collection

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figure1: Age spread of questionnaire respondents compared with 2001 United Kingdom census respondents.

Mentions: Members of the general public completed the questionnaire (93 male, 108 female, n=201). The age spread of the sample compared to 2001 population proportions can be seen in Figure 1. Respondents ranked quality indicators in order of importance within their specified categories (ie, 1 through 5 with 1 being the most important). Based on mean rankings, the quality indicators were arranged in order of preference within respective categories (Table 1). Similarly respondents were asked to rank the overall categories (statistics, staff, facilities, and access) (Table 2). The Friedman test was used to determine the statistical significance of the differences between the mean ranks obtained for the quality indicators within and between categories to determine the true order (Multimedia appendix 1). Final ranked order of quality indicators and categories was determined after statistical analyses (Table 3).


Identifying Quality Indicators Used by Patients to Choose Secondary Health Care Providers: A Mixed Methods Approach.

King D, Zaman S, Zaman SS, Kahlon GK, Naik A, Jessel AS, Nanavati N, Shah A, Cox B, Darzi A - JMIR Mhealth Uhealth (2015)

Age spread of questionnaire respondents compared with 2001 United Kingdom census respondents.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4526909&req=5

figure1: Age spread of questionnaire respondents compared with 2001 United Kingdom census respondents.
Mentions: Members of the general public completed the questionnaire (93 male, 108 female, n=201). The age spread of the sample compared to 2001 population proportions can be seen in Figure 1. Respondents ranked quality indicators in order of importance within their specified categories (ie, 1 through 5 with 1 being the most important). Based on mean rankings, the quality indicators were arranged in order of preference within respective categories (Table 1). Similarly respondents were asked to rank the overall categories (statistics, staff, facilities, and access) (Table 2). The Friedman test was used to determine the statistical significance of the differences between the mean ranks obtained for the quality indicators within and between categories to determine the true order (Multimedia appendix 1). Final ranked order of quality indicators and categories was determined after statistical analyses (Table 3).

Bottom Line: In keeping with many patient-facing platforms, most services currently providing comparative information on different providers do not take account of end-user requirements or the available evidence base.The mean differences between the other three categories hospital statistics, hospital staff, and hospital facilities, were not statistically significant.Staff competence was the most important indicator in the hospital staff category; cleanliness and up-to-date facilities were equally important in hospital facilities; ease of travel to the hospital was found to be most important in hospital access.

View Article: PubMed Central - HTML - PubMed

Affiliation: Imperial College London, London, United Kingdom. dominic.king@imperial.ac.uk.

ABSTRACT

Background: Patients in health systems across the world can now choose between different health care providers. Patients are increasingly using websites and apps to compare the quality of health care services available in order to make a choice of provider. In keeping with many patient-facing platforms, most services currently providing comparative information on different providers do not take account of end-user requirements or the available evidence base.

Objective: To investigate what factors were considered most important when choosing nonemergency secondary health care providers in the United Kingdom with the purpose of translating these insights into a ratings platform delivered through a consumer mHealth app.

Methods: A mixed methods approach was used to identify key indicators incorporating a literature review to identify and categorize existing quality indicators, a questionnaire survey to formulate a ranked list of performance indicators, and focus groups to explore rationales behind the rankings. Findings from qualitative and quantitative methodologies were mapped onto each other under the four categories identified by the literature review.

Results: Quality indicators were divided into four categories. Hospital access was the least important category. The mean differences between the other three categories hospital statistics, hospital staff, and hospital facilities, were not statistically significant. Staff competence was the most important indicator in the hospital staff category; cleanliness and up-to-date facilities were equally important in hospital facilities; ease of travel to the hospital was found to be most important in hospital access. All quality indicators within the hospital statistics category were equally important. Focus groups elaborated that users find it difficult to judge staff competence despite its importance.

Conclusions: A mixed methods approach is presented, which supported a patient-centered development and evaluation of a hospital ratings mobile app. Where possible, mHealth developers should use systematic research methods in order to more closely meet the needs of the end user and add credibility to their platform.

No MeSH data available.