出版社：Utrecht University, Maastricht University, Groningen University
摘要：Introduction : Knowing about LTC long term conditions patients´ experience with the care they receive is vital to advance towards a better and more patient centred integrated care. Although the latter is a core element of the theoretical framework of integrated care, there are few tools that measure the mentioned experience. The Basque Health Service already uses other tools IEMAC, and so on to self- assess the level of care integration of the Service Organizations SO, including Integrated Care Organizations, Mental Health Networks and Medium and Long Term Care Hospitals. Description of practice change implemented : the design of a 12 item scale IEXPAC, Chronic Patient´s Experience Assessment Tool, to be used by OS in a homogeneous way, that measures LTC patients´ care experience. The use of this tool by SO is included in the Contract-Programme CP, the centralized mechanism in the Basque Public Health System to assess and fund OS´ performance and activity. This scale will be used as a complement to other existing surveying tools. Aim : to Foster the assessment by the OS of the patient´s experience in order to improve the care provided. Targeted populations : LTC population user of the SO care. The CP has required a minimum number between 25 and 125 of surveyed LTC patients single pathology, pluripathology depending on the population attended by the SO. Timeline : the use of the scale has been rolled out along 2016 pilots and 2017 mainly in almost 16 out of 17 all the SO of the Basque Health Service. This implementation will be assessed in late2017 and 2018 within each SO´s CP general assessment. Highlights innovation, impact and outcomes : almost all the SO have surveyed, at least, the minimum number of patients requested. The total surveyed patients number is nearly 2,100 data analysis on 1,173 patients so far. There is a phone survey version, besides the face to face one, and the questionnaire is offered in the two official languages in the Basque Country. Sustainability and Transferability : There is an ongoing analysis of the possibility of adapting the survey to other patients groups children, rare diseases, frail elderly and other communication channels of the Health Service Health Folder, Health Advise, website, and so on, and of creating a specific one for caregivers. Conclusions, Discussion and lessons learnt : The survey use rate by the SO has been very high. There is an assessment currently being carried on to reflect on the usefulness of the tool for the care improvement in the SO. The preliminary outcomes note that IEXPAC is a valid tool for the general evaluation as a complement of other existing tools satisfaction surveys, IEMAC. Some SO have launched improvement actions as a result of their self-assessment e.g. the use of digital resources to get information and access services of the Health System. The use of internet resources and the digital access to the clinical record are, in fact, the items with the lowest frequency among the surveyed patients.
