Quality of care: a comparison of preferences between medical specialists and patients with chronic diseases.
In this study, we have looked for differences between medical specialists and patients with chronic diseases (COPD, rheumatoid arthritis and diabetes mellitus) in preferences of aspects of care in relation to the quality of care. Firstly, to enumerate relevant aspects for chronic diseases, open interviews and a concept mapping were conducted among patients with chronic disease, and medical specialists treating them. Here, the respondents have been asked to evaluate statements in relation to the quality of care. Secondly, a final questionnaire, including statements of nine relevant aspects of care, was presented to patients and medical specialists. The response rate among patients was 96% (N = 260) and among medical specialists 67% (N = 340). Both study populations ranked 'effectiveness of care' the highest. However, the difference in opinion between the two populations was significant, mainly due to the patient's giving a higher ranking to 'continuity of care' and a lower ranking to 'efficiency'. Significant differences were also found between the three patient groups on the aspects 'knowledge' and 'waiting time for treatment'. Patients with rheumatoid arthritis ranked 'knowledge' higher and 'waiting time for treatment' lower than did the other two patient groups. A lower level of education, having state-regulated health insurance and being older were associated with a higher preference for 'continuity'. Between the three groups of the medical specialists, no significant differences were found regarding to the profession, age, and sex.


CONCLUSIONS
the patients and medical specialists researched did not show wide differences of opinion on preferences of care in relation to quality. The only exception to this concerned 'continuity of care' which was ranked higher by patients.
van der Waal
M A
MA
Institute of Health Care Policy and Management, Faculty of Medicine and Health Sciences, Erasmus University, Rotterdam, The Netherlands.
Casparie
A F
AF
Lako
C J
CJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000523:psychology / Q000534:rehabilitation; D001291:Attitude of Health Personnel; D002908:Chronic Disease / Q000523:psychology*; D003924:Diabetes Mellitus, Type 2 / Q000523:psychology / Q000534:rehabilitation; D005260:Female; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000523:psychology / Q000534:rehabilitation; D008297:Male; D008511:Medicine; D008875:Middle Aged; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D011787:Quality of Health Care; D012803:Sick Role; D013038:Specialization; D016896:Treatment Outcome