System-Wide and Group-Specific Health Service Improvements: Cross-Sectional Survey of Outpatient Improvement Preferences and Associations with Demographic Characteristics

Elizabeth A. Fradgley, Christine L. Paul, Jamie Bryant, Alison Zucca and Christopher Oldmeadow
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Elizabeth A. Fradgley: Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, Callaghan, NSW 2308, Australia
Christine L. Paul: Priority Research Centre for Cancer Research, Innovation and Translation, University of Newcastle, Callaghan, NSW 2308, Australia
Jamie Bryant: Priority Research Centre for Health Behaviour, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia
Alison Zucca: Priority Research Centre for Health Behaviour, Hunter Medical Research Institute, University of Newcastle, Callaghan, NSW 2308, Australia
Christopher Oldmeadow: Hunter Medical Research Institute, HMRI Building, University of Newcastle, Callaghan, NSW 2308, Australia

IJERPH, 2018, vol. 15, issue 2, 1-16

Abstract: Efficient patient-centred quality improvement requires an understanding of the system-wide areas of dissatisfaction along with evidence to identify the programs which can be strategically targeted according to specific patient characteristics and preferences. This cross-sectional study reports the proportion of chronic disease outpatients selecting 23 patient-centred improvement initiatives. Using univariate tests and multivariable logistic regressions, this multi-site study also identifies initiatives differentially selected by outpatients according to clinical and demographic characteristics. A total of 475 outpatients participated (49% response). Commonly selected initiatives included: reducing wait-times (22.3%); convenient appointment scheduling (16.0%); and receiving up-to-date treatment information (16.0%). Within univariate tests, preferences for information and service accessibility initiatives were not significantly associated with specific subgroups. However, seven initiatives were preferred according to age, gender, diagnosis status, and chronic disease type within multivariate models. For example, neurology outpatients were more likely to select assistance to manage psychological symptoms when compared to oncology outpatients (OR: 2.89). Study findings suggest that system-wide programs to enhance information provision are strategic approaches to improve experiences across patient characteristics. Furthermore, a few initiatives can be targeted to specific groups and emphasized the importance of detailed scoping analyses and tailored implementation plans when designing patient-centred quality improvement programs.

Keywords: health services; outpatient; chronic disease; cancer or neoplasm; quality improvement; consumer participation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
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