International Journal for Quality in Health Care Advance Access originally published online on June 29, 2006
International Journal for Quality in Health Care 2006 18(4):266-274; doi:10.1093/intqhc/mzl014
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Factors that influence cancer patients’ overall perceptions of the quality of care
1 Department of Health Policy, Management, and Evaluation, University of Toronto, 2 Cancer Care Ontario, and 3 Faculty of Nursing, University of Toronto, Toronto, Ontario, Canada
Objective. This study outlines predictors of cancer patients’ overall perceptions of the quality of care.
Design and setting. Our sample included 2790 patients who received cancer care services during 2004 in 15 comprehensive cancer programmes across Ontario, Canada. Patients were classified into three groups: those receiving both chemotherapy and radiotherapy (n = 752), those receiving only chemotherapy (n = 1044), and those receiving only radiotherapy (n = 994). An ordinal logistic regression model for each patient group was performed to determine which variables most affected the probabilities of the patients’ overall evaluations of the quality of care. Potential control variables were patients’ age, sex, type of cancer, self-assessed health, and who completed the survey.
Results. Among seven common predictors of the overall quality perception across the three models, four should be of particular interest because patients perceived them as relatively problematic aspects of care. These are ‘was informed about follow-up care after completing treatment’, ‘knew next step in care’, ‘knew who to go to with questions’, and ‘providers were aware of test results’. These predictors explained between 25 and 34% of the variance (depending on the model) of the overall perception of quality. The explanatory power of these predictors did not change across sex and age group. ‘Self-assessed health’ was the only control variable that remained in all three models.
Conclusions. From a practical perspective, improvement efforts are best focused on factors that are strong predictors as well as on those for which there is a low score. Thus, on the basis of this study, practitioners’ improvement efforts might be constructively focused on the four predictors mentioned above.
Keywords: cancer patients, patient satisfaction, perceptions of the quality of care, predictors
Address reprint requests to Adalsteinn D. Brown, Department of Health Policy, Management, and Evaluation, University of Toronto, 155 College Street, Room 425, Toronto, Ontario, Canada M5T 3M6. E-mail: adalsteinn.brown{at}utoronto.ca
Accepted for publication April 28, 2006.
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