Evaluating quality of care for patients with rotator cuff disorders

被引：10

作者：

Eubank B.H.F. ^{[1
]}

Lafave M.R. ^{[1
]}

Preston Wiley J. ^{[2
]}

Sheps D.M. ^{[3
]}

Bois A.J. ^{[4
]}

Mohtadi N.G. ^{[2
]}

机构：

[1] Department of Health and Physical Education, Faculty of Health, Community, and Education, Mount Royal University, 4825 Mount Royal Gate SW, Calgary, T3E 6K6, AB

[2] Sport Medicine Centre, Faculty of Kinesiology, University of Calgary, 2500 University Drive NW, Calgary, T2N 1N4, AB

[3] Division of Orthopaedics, Department of Surgery, University of Alberta, 116 St and 85 Ave, Edmonton, T6G 2R3, AB

[4] Division of Shoulder and Elbow Surgery, Section of Orthopaedic Surgery, Cumming School of Medicine, University of Calgary, 2500 University Drive NW, Calgary, T2N 1N4, AB

来源：

BMC Health Services Research | / 18卷 / 1期

关键词：

Healthcare services; Patient satisfaction; Quality of healthcare; Resource utilization; Rotator cuff disease; Survey; Waiting times;

D O I：

10.1186/s12913-018-3375-4

中图分类号：

学科分类号：

摘要：

Background: Measuring quality in healthcare is vital in evaluating patient outcomes and system performance. The availability of reliable and valid information about the quality of care for patients presenting with rotator cuff disorders (RCD) in Alberta, Canada is scarce. The objective of this study is to measure quality of care for patients with RCD in order to identify areas of improvement. Methods: This study employs descriptive survey research design. Between March 2015 and November 2016, a convenience sample of patients presenting with chronic, full-thickness rotator cuff tears to two sport medicine centres in Calgary and Edmonton, Alberta completed two questionnaires: the Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ) and the Rotator Cuff Quality-of-Life Index (RC-QOL). Data collected using both questionnaires were used to make judgments about quality of care. Quality of care was evaluated using six dimensions of quality defined by the Alberta Quality Matrix for Health: accessibility, acceptability, efficiency, effectiveness, appropriateness, and safety. Data was also used to compare current patient clinical pathways to ideal clinical pathway algorithms and used to make judgments about the appropriateness and safety of healthcare practices. Results: One hundred seventy-one patients participated in the study. The longest mean waiting times for medical services in Alberta were for magnetic resonance imaging (MRI) received in the public sector (103 days) and consultation by orthopaedic surgeon (172 days). Patient satisfaction with respect to quality of care was lowest for emergency room physician and highest for orthopaedic surgeon visits. Patients were treated by a mean of 2.5 physicians (SD: 0.77, range: 2-7). The total aggregate average cost per patient was 4541.19. The mean RC-QOL score for all patients was 42 (SD: 22). Only 54 patients (64%) requiring surgery were able to consult with a surgeon within benchmark timeframes. A comparison of current to ideal clinical pathway algorithms found that 38 patients (22%) experienced indirect clinical pathways, whereby care was fragmented and patients received care from multiple and often, redundant healthcare professionals. Conclusion: There is a discrepancy between current and ideal clinical pathways whereby some patients are experiencing quality of care that is inefficient, disjointed, and less than ideal. © 2018 The Author(s).

引用

共 50 条

[1]

(2016)

[2]

(2001)

[3]

Jo Y.H., Lee K.H., Kim S.J., Kim J., Lee B.G., National Trends in surgery for rotator cuff disease in Korea, J Korean Med Sci, 32, 2, pp. 357-364, (2017)

[4]

Kemp K.A., Sheps D.M., Luciak-Corea C., Styles-Tripp F., Buckingham J., Beaupre L.A., Systematic review of rotator cuff tears in workers' compensation patients, Occup Med (Lond), 61, 8, pp. 556-562, (2011)

[5]

Tashjian R.Z., The natural history of rotator cuff disease: Evidence in 2016, Techn Shoulder & Elbow Surg, 17, 4, pp. 132-138, (2016)

[6]

The Burden of Musculoskeletal Diseases in the United States (BMUS), (2014)

[7]

Yamaguchi K., New guideline on rotator cuff problems, AAOS Now, 5, 1, pp. 1-4, (2011)

[8]

Backman C., Vanderloo S., Forster A.J., Measuring and improving quality in university hospitals in Canada: The Collaborative for Excellence in Healthcare Quality, Health Policy, 120, 9, pp. 982-986, (2016)

[9]

Chehade M.J., Burgess T.A., Bentley D.J., Ensuring quality of care through implementation of a competency-based musculoskeletal education framework, Arthritis Care Res (Hoboken), 63, 1, pp. 58-64, (2011)

[10]

Frank C., Marshall D., Faris P., Smith C., Essay for the CIHR/CMAJ award: Improving access to hip and knee replacement and its quality by adopting a new model of care in Alberta, CMAJ, 183, 6, pp. E347-E350, (2011)

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