1. T. Brzostek 1, L. Przewoźniak 1, P.Brzyski 1, M. Kózka 1, K.Gajda 1, M.Cisek 1, L. Aiken 2, W. Sermeus 3 1.Jagiellonian University Medical College, Krakow, Poland: Institute of Nursing and Midwifery, Department of Medical Sociology, Chair of Epidemiology and Preventive Medicine 2.University of Pennsylvania, USA 3.Catholic University Leuven, Belgium Factors influencing patients ’ willingness to recommend hospital as a place for therapy. Polish RN4CAST pilot study results. ESHMS 2010 Ghent 26-28.08.2010

2. Patient satisfaction is an important indicator of Healthcare Quality Started in 1994 yr. The Centre of Monitoring Healthcare Quality The primary goals Education about Healthcare Quality for Teams from Health Care Service. Implementation and Improvement of Accreditation Process. Health Technology Assessment (HTA) Monitoring three Categories of Indicators of HealthCare Quality: medical, quality of life and patient’ satisfaction. The PASAT program is applied by 94 hospitals and 13 outpatient clinic with accreditation of the CMHQ

3. Pilot study To accomplish objectives of the RN4CAST project (www.rn4cast.eu/en/index.php) in Poland, a pilot study was conducted in one 24/7 acute care hospital This presentation shows selected data of the Patient Satisfaction Questionnaire concerning received medical care.www.rn4cast.eu/en/index.php

4. Aim of the pilot study Assessment of quality of questionnaire in terms of patients’ ability to understand questionnaire items and the level of responsiveness Assessment of patients satisfaction expressed in terms of willingness to recommend the hospital as a place for therapy

5. Material and methods The study sample included 119 patients hospitalized in one hospital, in internal medicine (n= 59) and surgical (n=66) wards, who voluntary and anonymously agreed to participate in the study, and filled in the questionnaire. Survey method, self-report standardized questionnaire.

6. Questionnaire The questionnaire consisted of 14 items concerning different aspects of patients’ experiences during hospital stay: 1) respect showed by doctors (3 items) and by nurses (4 items) 2) hospital environment (2 items) 3) pharmacological management of pain (conditional, 2 items) 4) information about introduced new drug (conditional, 2 items) 5) assistance with physiological needs (conditional, 1 item) Response format: 4-item Likert scale: 1. never, 2. sometimes, 3. usually, 4. always 6) received information about possible side effects and self-care after leaving the hospital (2 items) Dichotomous response format

7. Background variables Type of unit, expected number of days to stay in the hospital, self-rated health, education level, Statistical analysis Multivariate logistic regression model – 9 models for every dimension of patient satisfaction separately Analysis was done with SPSS 15 for Windows Main outcome measure of patient satisfaction: „Would you recommend this hospital to your friends and family?”: definitely no, probably no, probably yes, definitely yes

8. Results 1 Quality of questionnaire 46% responders completed 100% of the questions 74% responders completed 90% of the questions (missing less than 2/24 questions) 90% responders completed 80% of the questions (missing less than 5/24 questions)

9. Results 2 Characteristics of the sample VariableCategory% EducationElementary33 Secondary53 University14 Self-rated health (SRH)Poor42 Mean17 Good32 Expected duration of the hospital stay<=2 days29 3-7 days52 8+ days19

10. Results 3 Percentage of patients entirely satisfied with: 1. respect showed by doctors70 2. respect showed by nurses53 1+2. respect showed by medical staff67 3. hospital environment53 4. pharmacological management of pain c 74 5. introducing new drug c 58 4+5. pharmacology c 51 6. assistance with physiological needs c 77 summary measure of satisfaction33 7. full information about self care after hospital leaving77 Lack of doubts when recommending the hospital: 58%

11. lack of satisfaction with:OR95%CI 1. respect showed by doctors40.53.58 – 457 2. respect showed by nurses 3.640.88 – 15.1 1+2. respect showed by medical staff8.781.65 - 46.8 3. hospital environment 1.951.950.58 – 6.53 4. pharmacological management of pain c 7.461.15 - 48.5 5. introducing new drug c 13.41.75 – 103 4+5. pharmacology c 31.41.40 - 706 6. assistance with physiological needs c 1.000.08 – 11.5 summary measure of satisfaction 2.770.36 – 21.7 Odd-ratio of having doubts when recommending the hospital related to Results 4

12. Odd-ratio of having doubts when recommending the hospital 1.Patients who did not obtained full information about self-care after leaving the hospital had higher odds (OR=4,3) of having doubts in models regarding respect from medical staff. 2.Patient who expected to stay in hospital from 3 to 7 days had lower odds (OR=0,2) of having doubts. 3.Patients with poor and mean SRH had higher odds (OR=3,1) of having doubts. Results 5

13. Conclusions: lack of respect from medical staff, especially from physicians, effective pain management lack of full information concerning: 1. The questionnaire was well received, understood, the response level was high and logical. 2. Factors influencing willingness to recommend the hospital as a place for treatment are: introduction of the new drugs, possible side effects and self-care after leaving hospital.