Improving clinical outcomes and patient satisfaction among patients with coronary artery disease: an example of enhancing regional integration between a cardiac centre and a referring hospital
Abstract Background Value-based healthcare (VBHC) is a promising strategy to increase patient value. For a successful implementation of VBHC, intensive collaborations between organizations and integrated care delivery systems are key conditions. Our aim was to evaluate the effects of a pilot study r...
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| Format: | Article |
| Language: | English |
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BMC
2020-06-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-020-05352-w |
| _version_ | 1817989148239200256 |
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| author | Dennis van Veghel Mohamed Soliman-Hamad Daniela N. Schulz Bernard Cost Timothy A. Simmers Lukas R. C. Dekker |
| author_facet | Dennis van Veghel Mohamed Soliman-Hamad Daniela N. Schulz Bernard Cost Timothy A. Simmers Lukas R. C. Dekker |
| author_sort | Dennis van Veghel |
| collection | DOAJ |
| description | Abstract Background Value-based healthcare (VBHC) is a promising strategy to increase patient value. For a successful implementation of VBHC, intensive collaborations between organizations and integrated care delivery systems are key conditions. Our aim was to evaluate the effects of a pilot study regarding enhancing regional integration between a cardiac centre and a referring hospital on patient-relevant clinical outcomes and patient satisfaction. Methods The study population consisted of a sample of patients treated for coronary artery disease by use of a coronary artery bypass graft (CABG) or a percutaneous coronary intervention between 2011 and 2016. Since 2013, the two hospitals have implemented different interventions to improve clinical outcomes and the degree of patient satisfaction, e.g. improvement of communication, increased consultant capacity, introduction of outpatient clinic for complex patients, and improved guideline adherence. To identify intervention effects, logistic regression analyses were conducted. Patients’ initial conditions, like demographics and health status, were included in the model as predictors. Clinical data extracted from the electronic health records and the hospitals’ cardiac databases as well as survey-based data were used. Results Our findings indicate a non-significant increase of event-free survival of patients treated for coronary artery disease between 2014 and 2016 compared to patients treated between 2011 and 2013 (97.4% vs. 96.7% respectively). This non-significant improvement over time has led to significant better outcomes for patients referred from the study referring hospital compared to patients referred from other hospitals. The level of patient satisfaction (response rate 32.2%; 216 out of 669) was improved and reached statistically significant higher scores regarding patient information and education (p = .013), quality of care (p = .007), hospital admission and stay (p = .032), personal contact with the physician (p = .024), and total impression (p = .007). Conclusions This study shows a promising effect of regional integration. An intensified collaboration in the care chain, organized in a structured manner between a cardiac centre and a referring hospital and aiming at high quality, resulted in successful improvement of clinical outcomes and degree of patient satisfaction. The applied method may be used as a starting point of regional integration with other referring hospitals. We encourage others to organize the whole care chain to continuously improve patient-relevant outcomes and patient satisfaction. Trial registration ISRCTN11311830 . Registered 01 October 2018 (retrospectively registered). |
| first_indexed | 2024-04-14T00:43:22Z |
| format | Article |
| id | doaj.art-7f2acdeb435e421aa0d117651adee4c6 |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-04-14T00:43:22Z |
| publishDate | 2020-06-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-7f2acdeb435e421aa0d117651adee4c62022-12-22T02:22:07ZengBMCBMC Health Services Research1472-69632020-06-012011810.1186/s12913-020-05352-wImproving clinical outcomes and patient satisfaction among patients with coronary artery disease: an example of enhancing regional integration between a cardiac centre and a referring hospitalDennis van Veghel0Mohamed Soliman-Hamad1Daniela N. Schulz2Bernard Cost3Timothy A. Simmers4Lukas R. C. Dekker5Catharina ZiekenhuisCatharina ZiekenhuisCatharina ZiekenhuisSJG WeertCatharina ZiekenhuisCatharina ZiekenhuisAbstract Background Value-based healthcare (VBHC) is a promising strategy to increase patient value. For a successful implementation of VBHC, intensive collaborations between organizations and integrated care delivery systems are key conditions. Our aim was to evaluate the effects of a pilot study regarding enhancing regional integration between a cardiac centre and a referring hospital on patient-relevant clinical outcomes and patient satisfaction. Methods The study population consisted of a sample of patients treated for coronary artery disease by use of a coronary artery bypass graft (CABG) or a percutaneous coronary intervention between 2011 and 2016. Since 2013, the two hospitals have implemented different interventions to improve clinical outcomes and the degree of patient satisfaction, e.g. improvement of communication, increased consultant capacity, introduction of outpatient clinic for complex patients, and improved guideline adherence. To identify intervention effects, logistic regression analyses were conducted. Patients’ initial conditions, like demographics and health status, were included in the model as predictors. Clinical data extracted from the electronic health records and the hospitals’ cardiac databases as well as survey-based data were used. Results Our findings indicate a non-significant increase of event-free survival of patients treated for coronary artery disease between 2014 and 2016 compared to patients treated between 2011 and 2013 (97.4% vs. 96.7% respectively). This non-significant improvement over time has led to significant better outcomes for patients referred from the study referring hospital compared to patients referred from other hospitals. The level of patient satisfaction (response rate 32.2%; 216 out of 669) was improved and reached statistically significant higher scores regarding patient information and education (p = .013), quality of care (p = .007), hospital admission and stay (p = .032), personal contact with the physician (p = .024), and total impression (p = .007). Conclusions This study shows a promising effect of regional integration. An intensified collaboration in the care chain, organized in a structured manner between a cardiac centre and a referring hospital and aiming at high quality, resulted in successful improvement of clinical outcomes and degree of patient satisfaction. The applied method may be used as a starting point of regional integration with other referring hospitals. We encourage others to organize the whole care chain to continuously improve patient-relevant outcomes and patient satisfaction. Trial registration ISRCTN11311830 . Registered 01 October 2018 (retrospectively registered).http://link.springer.com/article/10.1186/s12913-020-05352-wRegional integrationCardiac careCoronary artery diseasePatient satisfactionValue-based health careOutcome measures |
| spellingShingle | Dennis van Veghel Mohamed Soliman-Hamad Daniela N. Schulz Bernard Cost Timothy A. Simmers Lukas R. C. Dekker Improving clinical outcomes and patient satisfaction among patients with coronary artery disease: an example of enhancing regional integration between a cardiac centre and a referring hospital BMC Health Services Research Regional integration Cardiac care Coronary artery disease Patient satisfaction Value-based health care Outcome measures |
| title | Improving clinical outcomes and patient satisfaction among patients with coronary artery disease: an example of enhancing regional integration between a cardiac centre and a referring hospital |
| title_full | Improving clinical outcomes and patient satisfaction among patients with coronary artery disease: an example of enhancing regional integration between a cardiac centre and a referring hospital |
| title_fullStr | Improving clinical outcomes and patient satisfaction among patients with coronary artery disease: an example of enhancing regional integration between a cardiac centre and a referring hospital |
| title_full_unstemmed | Improving clinical outcomes and patient satisfaction among patients with coronary artery disease: an example of enhancing regional integration between a cardiac centre and a referring hospital |
| title_short | Improving clinical outcomes and patient satisfaction among patients with coronary artery disease: an example of enhancing regional integration between a cardiac centre and a referring hospital |
| title_sort | improving clinical outcomes and patient satisfaction among patients with coronary artery disease an example of enhancing regional integration between a cardiac centre and a referring hospital |
| topic | Regional integration Cardiac care Coronary artery disease Patient satisfaction Value-based health care Outcome measures |
| url | http://link.springer.com/article/10.1186/s12913-020-05352-w |
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