Quality of care information: striking a balance between patients, health care providers, and insurance companies

Do the numbers tell the tale? It depends both on the way in which you ask patients about their experiences and how you analyse and present the results. This has emerged from research conducted at the Netherlands Institute for Health Services Research (NIVEL) by Maarten Krol for his doctoral thesis. He received his PhD from Tilburg University on June 12.
 

Patient experiences have become an important source of quality of care information. In Dutch health care, where a system of regulated competition is in place, this information is used not only by patients, but also by health care providers and health care insurers. Because of this, the questionnaires’ validity must be thoroughly substantiated.
 
Different purposes
Although a valid patient experience questionnaire measures aspects of health care relevant for all concerned parties, it particularly measures those aspects that are relevant for patients. Various methods are used to involve patients in the process of developing and tailoring these questionnaires. This will remain a focal point, because these questionnaires serve different purposes for health care providers and health care insurers. For example, patients consider the way they are dealt with and information provision to be very important, while health care providers and insurers focus more on the effects of the treatment.
 
In line with needs and preferences
Maarten Krol’s doctoral thesis shows how important it is to examine the answers and the relationships between them in order to understand the consequences of tailoring a questionnaire.
“What is really needed is a single question that would summarise patient experiences and satisfaction – for instance, a rating, or whether a patient would recommend the health care provider. However, such a question would need to sufficiently reflect the individual experiences reported by patients,” says Krol.
In addition, it’s important to analyse and present patient experiences in a way that is in line with the needs and preferences of the concerned parties.
 
Striking a balance
“Early on in every study, you need to determine for whom the results are relevant and how to best present them. Health care providers are very interested in knowing exactly what’s going well, or what’s not going well, with respect to the care they provide. But this kind of detailed information can be confusing for patients if they want to compare health care providers,” according to Krol. “And if a summary is too brief, it can lead to an oversimplified version of reality. Unfortunately, ‘one size fits all’ doesn’t apply here, and presenting quality of care information remains a balancing act.”

Funding
Ministry of Education, Culture and Science