title: Relationship between clinical quality and patient experience: analysis of data from the english quality and outcomes framework and the National GP Patient Survey.
abstract: OBJECTIVE
  Clinical quality and patient experience are both widely used to evaluate the quality of health care, but the relationship between these 2 domains remains uncertain. The aim of this study was to examine this relationship using data from 2 established measures of quality in primary care in England.
  
  
  METHODS
  Practice-level analyses (N = 7,759 practices in England) were conducted on measures of patient experience from the national General Practice Patient Survey (GPPS), and measures of clinical quality from the national pay-for-performance scheme (Quality and Outcomes Framework). Spearman's rank correlation and multiple linear regression were used on practice-level estimates.
  
  
  RESULTS
  Although all the correlations between clinical quality summary scores and patient survey scores are positive, and most are statistically significant, the strength of the associations was weak, with the highest correlation coefficient reaching 0.18, and more than one-half were 0.11 or less. Correlations with clinical quality were highest for patient-reported access scores (telephone access 0.16, availability of urgent appointments 0.15, ability to book ahead 0.18, ability to see preferred doctor 0.17) and overall satisfaction (0.15).
  
  
  CONCLUSIONS
  Although there are associations between clinical quality and measures of patient experience, the 2 domains of care quality remain predominantly distinct. The strongest correlations are observed between practice clinical quality and practice access, with very low correlations between clinical quality and interpersonal aspects of care. The quality of clinical care and the quality of interpersonal care should be considered separately to give an overall assessment of medical care.
authors.affiliation: University of Cambridge, Cambridge, England.
authors.forename: Nadia R
authors.initials: NR
authors.lastname: Llanwarne
authors.forename: Gary A
authors.initials: GA
authors.lastname: Abel
authors.forename: Marc N
authors.initials: MN
authors.lastname: Elliott
authors.forename: Charlotte A M
authors.initials: CA
authors.lastname: Paddison
authors.forename: Georgios
authors.initials: G
authors.lastname: Lyratzopoulos
authors.forename: John L
authors.initials: JL
authors.lastname: Campbell
authors.forename: Martin
authors.initials: M
authors.lastname: Roland
mesh_terms: D001071:Appointments and Schedules; D003266:Continuity of Patient Care; D003430:Cross-Sectional Studies; D004739:England; D058006:General Practice / Q000592:standards*; D019538:Health Care Surveys; D006297:Health Services Accessibility; D006801:Humans; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011787:Quality of Health Care
keywords: clinical quality; health care; patient experience; quality indicators; quality of health care; technical quality of care
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