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Patient Admission Preferences and Perceptions.

Wu C, Melnikow J, Dinh T, Holmes JF, Gaona SD, Bottyan T, Paterniti D, Nishijima DK - West J Emerg Med (2015)

Bottom Line: Out of 302 study patients, the ability for family and friends to visit (83%), nurse availability (80%), and physician availability (79%) were the factors most commonly rated "very important," while the cost of hospitalization (62%) and length of hospitalization (59%) were the factors least commonly rated "very important." When asked to choose between the ICU and the floor if they were the patient in the scenario, 33 patients (10.9%) choose the ICU, 133 chose the floor (44.0%), and 136 (45.0%) had no preference.Based on a hypothetical scenario of mild TBI, the majority of patients preferred admission to the floor or had no preference compared to admission to the ICU.Humanistic factors such as the availability of doctors and nurses and the ability to interact with family appear to have a greater priority than systematic factors of hospitalization, such as length and cost of hospitalization or length of time in the ED waiting for an in-patient bed.

View Article: PubMed Central - PubMed

Affiliation: University of California, Davis, School of Medicine, Department of Emergency Medicine, Sacramento, California.

ABSTRACT

Introduction: Understanding patient perceptions and preferences of hospital care is important to improve patients' hospitalization experiences and satisfaction. The objective of this study was to investigate patient preferences and perceptions of hospital care, specifically differences between intensive care unit (ICU) and hospital floor admissions.

Methods: This was a cross-sectional survey of emergency department (ED) patients who were presented with a hypothetical scenario of a patient with mild traumatic brain injury (TBI). We surveyed their preferences and perceptions of hospital care related to this scenario. A closed-ended questionnaire provided quantitative data on patient preferences and perceptions of hospital care and an open-ended questionnaire evaluated factors that may not have been captured with the closed-ended questionnaire.

Results: Out of 302 study patients, the ability for family and friends to visit (83%), nurse availability (80%), and physician availability (79%) were the factors most commonly rated "very important," while the cost of hospitalization (62%) and length of hospitalization (59%) were the factors least commonly rated "very important." When asked to choose between the ICU and the floor if they were the patient in the scenario, 33 patients (10.9%) choose the ICU, 133 chose the floor (44.0%), and 136 (45.0%) had no preference.

Conclusion: Based on a hypothetical scenario of mild TBI, the majority of patients preferred admission to the floor or had no preference compared to admission to the ICU. Humanistic factors such as the availability of doctors and nurses and the ability to interact with family appear to have a greater priority than systematic factors of hospitalization, such as length and cost of hospitalization or length of time in the ED waiting for an in-patient bed.

No MeSH data available.


Related in: MedlinePlus

Hypothetical clinical scenario.CT, computed tomography
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f1-wjem-16-707: Hypothetical clinical scenario.CT, computed tomography

Mentions: The closed-ended questionnaire was administered to 302 eligible patients. We considered this sample size adequate to generate sufficiently narrow confidence intervals (CIs). The questionnaire included background questions, a clinical scenario, and multiple choice questions. Background questions evaluated relevant patient characteristics including self-reported general health, race, ethnicity, education level, insurance status, and prior experiences with ED and in-hospital care. Patients then read a clinical scenario where they suffered a TBI with a small intracranial hemorrhage diagnosed on head computed tomography (Figure). This particular clinical scenario involving TBI was chosen because we previously demonstrated that many low-risk patients with TBI and intracranial hemorrhage likely do not require ICU admission and wide variability of ICU admission practices exists across trauma centers. 8–11


Patient Admission Preferences and Perceptions.

Wu C, Melnikow J, Dinh T, Holmes JF, Gaona SD, Bottyan T, Paterniti D, Nishijima DK - West J Emerg Med (2015)

Hypothetical clinical scenario.CT, computed tomography
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4644039&req=5

f1-wjem-16-707: Hypothetical clinical scenario.CT, computed tomography
Mentions: The closed-ended questionnaire was administered to 302 eligible patients. We considered this sample size adequate to generate sufficiently narrow confidence intervals (CIs). The questionnaire included background questions, a clinical scenario, and multiple choice questions. Background questions evaluated relevant patient characteristics including self-reported general health, race, ethnicity, education level, insurance status, and prior experiences with ED and in-hospital care. Patients then read a clinical scenario where they suffered a TBI with a small intracranial hemorrhage diagnosed on head computed tomography (Figure). This particular clinical scenario involving TBI was chosen because we previously demonstrated that many low-risk patients with TBI and intracranial hemorrhage likely do not require ICU admission and wide variability of ICU admission practices exists across trauma centers. 8–11

Bottom Line: Out of 302 study patients, the ability for family and friends to visit (83%), nurse availability (80%), and physician availability (79%) were the factors most commonly rated "very important," while the cost of hospitalization (62%) and length of hospitalization (59%) were the factors least commonly rated "very important." When asked to choose between the ICU and the floor if they were the patient in the scenario, 33 patients (10.9%) choose the ICU, 133 chose the floor (44.0%), and 136 (45.0%) had no preference.Based on a hypothetical scenario of mild TBI, the majority of patients preferred admission to the floor or had no preference compared to admission to the ICU.Humanistic factors such as the availability of doctors and nurses and the ability to interact with family appear to have a greater priority than systematic factors of hospitalization, such as length and cost of hospitalization or length of time in the ED waiting for an in-patient bed.

View Article: PubMed Central - PubMed

Affiliation: University of California, Davis, School of Medicine, Department of Emergency Medicine, Sacramento, California.

ABSTRACT

Introduction: Understanding patient perceptions and preferences of hospital care is important to improve patients' hospitalization experiences and satisfaction. The objective of this study was to investigate patient preferences and perceptions of hospital care, specifically differences between intensive care unit (ICU) and hospital floor admissions.

Methods: This was a cross-sectional survey of emergency department (ED) patients who were presented with a hypothetical scenario of a patient with mild traumatic brain injury (TBI). We surveyed their preferences and perceptions of hospital care related to this scenario. A closed-ended questionnaire provided quantitative data on patient preferences and perceptions of hospital care and an open-ended questionnaire evaluated factors that may not have been captured with the closed-ended questionnaire.

Results: Out of 302 study patients, the ability for family and friends to visit (83%), nurse availability (80%), and physician availability (79%) were the factors most commonly rated "very important," while the cost of hospitalization (62%) and length of hospitalization (59%) were the factors least commonly rated "very important." When asked to choose between the ICU and the floor if they were the patient in the scenario, 33 patients (10.9%) choose the ICU, 133 chose the floor (44.0%), and 136 (45.0%) had no preference.

Conclusion: Based on a hypothetical scenario of mild TBI, the majority of patients preferred admission to the floor or had no preference compared to admission to the ICU. Humanistic factors such as the availability of doctors and nurses and the ability to interact with family appear to have a greater priority than systematic factors of hospitalization, such as length and cost of hospitalization or length of time in the ED waiting for an in-patient bed.

No MeSH data available.


Related in: MedlinePlus