Algorithm of patient’s quality of life monitoring to control quality of medical care and its testing in the Clinic of High Medical Technologies named after N.I. Pirogov of St. Petersburg State University

In patient-centered health care, patients’ perspective about treatment outcomes, namely their quality of life (QoL), is an important indicator of quality of medical care.
Aim. To develop the algorithm for QoL monitoring and satisfaction with treatment outcomes among patients receiving inpatient care to control its quality and test the algorithm across patients undergoing surgery.
Materials and methods. The algorithm was tested within a single-center prospective cohort observational study among adult patients who received surgical treatment in the Department of Cardiovascular Surgery and the Department of Gynecology of St. Petersburg State University Hospital. The analysis was performed in the group of 2117 patients (mean age 56.5 years, 71.8 % women). Statistical analysis included the Wilcoxon test, χ² and generalized estimating equations.
Results. The developed algorithm included the following milestones: selection of questionnaires – EQ-5D for QoL assessment, Picker questionnaire for patient’s experience about hospital stay, IMPSS for satisfaction with treatment outcomes; creation of electronic forms of instruments and their integration into the medical information system; determination of the assessment time-points and the format of monitoring; elaboration of the principles of questionnaires data analysis. For the significant amount of patients steady positive changes of their wellbeing after treatment were established. The appearance of meaningful problems at discharge was registered in less than 1.5 % of patients. The vast majority of patients were satisfied with treatment outcomes. Positive experience of hospital stay was observed by most patients. Identified areas of hospital stay that can be improved are consideration of patient preferences, continuity of care, and psychological aspect.
Conclusion. Implementation of the developed algorithm into the quality management system in medical institutions could be of value to control quality of medical care with the focus on patient-reported outcomes and could contribute to the patient-centeredness of care.

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