Patient Perspectives on Coordinated Care: Preliminary Results from the Implementation Stage Using Patient-Reported Experience Measures (PREMs)
Abstract
:1. Introduction
“Care coordination is the deliberate organization of patient care activities between two or more participants (including the patient) involved in a patient’s care to facilitate the appropriate delivery of health care services. Organizing care involves the marshaling of personnel and other resources needed to carry out all required patient care activities and is often managed by the exchange of information among participants responsible for different aspects of care”.[13]
2. Materials and Methods
3. Results
3.1. Patient’s Participation in the Treatment Process (A)
3.2. Patient Support in Decision-Making (B)
3.3. Continuity of Care (C)
3.4. Coordination of Care (D)
3.5. Solving the Patient’s Problems (E)
3.6. Flexibility and Availability of Care
3.7. Approach to the Patient
3.8. Summary Evaluation of the Questionnaire Results
3.9. Analysis Comparing Improvements in Each Area
4. Discussion
4.1. Patient’s Participation in the Treatment Process (A)
4.2. Continuity of Care (C)
4.3. Coordination of Care (D)
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
CBOS | Center for Social Opinion Research |
CC | Coordinated Care |
GDP | Gross Domestic Product |
HLS | Health Literacy Survey |
JOP-POP | Patient Service Quality—Supply |
POZ PLUS | Primary Healthcare Plus Project |
PREM | Patient-Reported Experience Measure |
PROM | Patient-Reported Outcome Measure |
SHA | System of Health Accounts |
VA | Value Added |
VBHC | Value-Based Healthcare |
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Variable | Feature | N | % |
---|---|---|---|
Gender | Female | 28 | 70 |
Male | 12 | 30 | |
Age | Up to 35 years | 3 | 7.5 |
36–50 years | 11 | 27.5 | |
51–65 years | 13 | 32.5 | |
Over 65 years | 13 | 32.5 | |
Place of residence | Village | 8 | 20 |
City | 32 | 80 | |
Education | Primary | 2 | 5 |
Vocational | 7 | 17.5 | |
Secondary | 11 | 27.5 | |
Higher | 20 | 50 | |
Coordinated care pathway | Diabetology | 9 | 22.5 |
Endocrinology | 14 | 35 | |
Cardiology | 17 | 42.5 | |
Number of chronic diseases | 1 | 13 | 32.5 |
2–3 | 21 | 52.5 | |
>3 | 6 | 15 |
Area | Summary Rating “Before” (Median, Quartiles) | Overall Rating “After” (Median, Quartiles) | p |
---|---|---|---|
A (Q1–Q5) | 22.5 (19.5; 24.0) | 23.0 (21.0; 24.0) | 0.0015 |
B (Q6–Q9) | 18.0 (15.0; 19.0) | 18.0 (17.0; 19.0) | 0.0010 |
C (Q10–Q13) | 16.5 (14.0; 19.0) | 18.0 (15.5; 19.0) | 0.0002 |
D (Q14–Q17) | 13.0 (10.0; 17.0) | 15.0 (13.0; 17.0) | 0.0001 |
E (Q18–Q22) | 21.0 (18.0; 24.0) | 21.5 (19.0; 24.0) | 0.0001 |
F (Q23–Q25) | 13.0 (11.0; 14.0) | 13.0 (11.0; 14.0) | 0.0069 |
G (Q26–29) | 17.0 (14.0; 19.0) | 17.0 (14.0; 19.0) | 0.0409 |
Study Area | NoQ | Statements | p |
---|---|---|---|
A. Patient’s participation in the treatment process | Q1 | My doctor appreciates my opinion about the treatment, its course and results. | 0.0679 |
Q2 | My doctor has enough time to listen to me and answer my questions. | 0.0431 | |
Q3 | My doctor discusses with me the next steps in the treatment of my disease. | 0.0679 | |
Q4 | My doctor gives me the opportunity to choose the method of treatment if there are different methods of therapy (treatment) for my disease. | 0.0679 | |
Q5 | My doctor wants me to talk about various issues related to my health, such as the side effects of the medications used and the course of other conditions. | 0.0180 | |
B. Patient support in decision-making | Q6 | My doctor informs me of additional tests and medical consultations recommended for my chronic illness. | 0.1415 |
Q7 | My doctor or another member of the medical staff helps me determine what needs to be changed in my lifestyle to better manage my chronic illness. | 0.0180 | |
Q8 | My doctor or another member of the medical staff gives me information materials (brochures, leaflets) explaining how to deal with my illness. | 0.0007 | |
Q9 | I have free access to my medical records. | 0.1797 | |
C. Continuity of care | Q10 | I have a doctor assigned. | >0.999 |
Q11 | I have the opportunity to continue specialized treatment without having to constantly visit the family doctor to get referrals. | 0.0218 | |
Q12 | My doctor has information about the recommendations that other doctors give me, what medications they prescribe for me, what procedures I have had in other medical institutions | 0.0431 | |
Q13 | I have regular diagnostic tests and follow-up visits due to my chronic illness. | 0.0033 | |
D. Coordination of care | Q14 | I have a designated person from the medical staff (doctor, nurse) who organizes all my care in the healthcare system. | 0.0002 |
Q15 | The doctors who treat me do not contradict each other; I get consistent/the same medical advice from different doctors. | 0.5930 | |
Q16 | My doctor consults other doctors to discuss my condition. | 0.0117 | |
Q17 | I receive comprehensive healthcare related to my chronic illness—I can attend many different medical consultations at the same medical facility (e.g., with a dietitian or a physical therapist). | 0.0032 | |
E. Solving the patient’s problems | Q18 | My doctor explains the aims of the treatment, the treatment process, and the expected results. | 0.0180 |
Q19 | My doctor or another member of the clinic staff explains to me what to do next with the treatment, where to go next, how to proceed, who to contact, etc. | 0.0756 | |
Q20 | My doctor or another person from the medical staff gives me instructions on how to act in the event of a sudden deterioration in health or exacerbation of the signs and symptoms of the disease. | 0.0110 | |
Q21 | I can request a home visit from a doctor or a nurse. | 0.1925 | |
Q22 | I can contact the person responsible for my care (community nurse, my doctor) by phone or email. | 0.0619 | |
F. Availability and flexibility of care | Q23 | I can choose a convenient date for my visit. | 0.0071 |
Q24 | I have access to information about the services offered and the waiting time (e.g., by phone, on the website of the institution). | 0.0759 | |
Q25 | The results of my laboratory tests are available on time, i.e., before my next visit to my doctor. | >0.999 | |
G. Approach to the patient | Q26 | The staff of the facility respond quickly to my needs; I feel the staff are interested in me. | 0.0587 |
Q27 | In the facility, there is access to information about the patient’s rights, including the possibilities and ways of managing a complaint or contact with a supervisor. | 0.1797 | |
Q28 | The facility where I am treated is interested in what patients think about it; it conducts satisfaction research. | 0.3613 | |
Q29 | The facility where I am being treated is making changes that I believe will improve patient services. | >0.999 |
Area | Median | Q1–Q3 | Average Sum of Ranks | Ranking |
---|---|---|---|---|
A. Patient’s participation in the treatment process | 0.0 | 0.0–1.0 | 125.44 | V |
B. Patient support in decision-making | 0.0 | 0.0–2.0 | 141.85 | Iv |
C. Continuity of care | 0.5 | 0.0–1.0 | 143.16 | Iii |
D. Coordination of care | 1.0 | 0.0–3.0 | 175.78 | I |
E. Solving patient’s problems | 1.0 | 0.0–2.0 | 161.35 | Ii |
F. Flexibility and availability of care | 0.0 | 0.0–1.0 | 124.73 | Vi |
G. Approach to the patient | 0.0 | 0.0–0.5 | 111.20 | Vii |
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Wieczorek-Wójcik, B.; Milewska, A.J.; Kilańska, D.; Kulma-Pytlak, A.; Iltchev, P.; Gaworska-Krzemińska, A.; Kozlowski, R. Patient Perspectives on Coordinated Care: Preliminary Results from the Implementation Stage Using Patient-Reported Experience Measures (PREMs). Healthcare 2025, 13, 1026. https://doi.org/10.3390/healthcare13091026
Wieczorek-Wójcik B, Milewska AJ, Kilańska D, Kulma-Pytlak A, Iltchev P, Gaworska-Krzemińska A, Kozlowski R. Patient Perspectives on Coordinated Care: Preliminary Results from the Implementation Stage Using Patient-Reported Experience Measures (PREMs). Healthcare. 2025; 13(9):1026. https://doi.org/10.3390/healthcare13091026
Chicago/Turabian StyleWieczorek-Wójcik, Beata, Anna Justyna Milewska, Dorota Kilańska, Aneta Kulma-Pytlak, Peter Iltchev, Aleksandra Gaworska-Krzemińska, and Remigiusz Kozlowski. 2025. "Patient Perspectives on Coordinated Care: Preliminary Results from the Implementation Stage Using Patient-Reported Experience Measures (PREMs)" Healthcare 13, no. 9: 1026. https://doi.org/10.3390/healthcare13091026
APA StyleWieczorek-Wójcik, B., Milewska, A. J., Kilańska, D., Kulma-Pytlak, A., Iltchev, P., Gaworska-Krzemińska, A., & Kozlowski, R. (2025). Patient Perspectives on Coordinated Care: Preliminary Results from the Implementation Stage Using Patient-Reported Experience Measures (PREMs). Healthcare, 13(9), 1026. https://doi.org/10.3390/healthcare13091026