title: Health care quality from the perspective of health care providers and patients during and shortly after acute care restructuring in Newfoundland and Labrador.
abstract: OBJECTIVE
  To monitor changes in providers' perceptions of health care quality and the importance of health reform, and in patients' satisfaction with services during and two years after restructuring, comparing the region of the province that was restructured (St John's) with those regions in which hospitals were not aggregated.
  
  
  METHODS
  The Employee Attitude Survey questionnaire was sent to acute care providers (n = 5353) to assess personal characteristics and perceptions of the impact of reform on workplace conditions, work-related attitudes and turnover intentions. The response rate for 2000 and 2002 was 42% (n = 1222 and 1034, respectively). Only respondents in both surveys (n = 589) were used in the analysis because study results were the same for both the repeat sample and total samples. A Patient Satisfaction Survey questionnaire was administered to patients discharged from acute care facilities in 2000 (n = 1741) and 2002 (n = 704). Response rates were 82.5% and 90.2%, respectively.
  
  
  RESULTS
  Most providers felt, at both time periods, that restructuring of the health care system was a positive step, but felt that health care quality was low. In the St John's region, perceptions of quality and standards of care improved over time. Patients were extremely satisfied with the admission process and hospital stay at both time periods in St John's. However, satisfaction declined in 2002 in regions outside St John's.
  
  
  CONCLUSIONS
  Aggregation of acute care hospitals is possible without adverse effects on providers' perceptions of health care quality or on patient satisfaction.
authors.affiliation: Patient Research Centre, Health Care Corporation, St. Johns, Newfoundland and Labrador, Canada.
authors.forename: Deborah
authors.initials: D
authors.lastname: Gregory
authors.forename: Christine
authors.initials: C
authors.lastname: Way
authors.forename: Brendan
authors.initials: B
authors.lastname: Barrett
authors.forename: Patrick
authors.initials: P
authors.lastname: Parfrey
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D005260:Female; D018166:Health Care Reform; D006752:Hospital Planning; D006754:Hospital Restructuring; D006801:Humans; D008297:Male; D008875:Middle Aged; D009523:Newfoundland and Labrador; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D010564:Personnel, Hospital / Q000523:psychology; D011787:Quality of Health Care; D012040:Regional Health Planning / Q000458:organization & administration*; D011795:Surveys and Questionnaires