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1 – 4 of 4José Labarère, Magali Fourny, Vittoz Jean‐Phillippe, Stéphanie Marin‐Pache and François Patrice
The objective of this study was to check psychometric properties of a French‐language in‐patient experience questionnaire in a test sample different from the development sample…
Abstract
The objective of this study was to check psychometric properties of a French‐language in‐patient experience questionnaire in a test sample different from the development sample. The questionnaire was sent out to 5,736 in‐patients, within two to four weeks of discharge from a teaching hospital of 2,200 beds. Overall 4,095 questionnaires (71.4 per cent) were returned. Of these, 3,879 questionnaires were analyzed. In principal component analysis, seven principal components accounted for 62.4 per cent of the total variance. Cronbach’s alpha coefficient ranged from 0.62 to 0.90, with the exception of the seventh scale (convenience scale, two items, Cronbach=0.39). The overall patient experience score increased with increasing patient age (except for patients older than 65), male sex, low education level, use of a single room, and prior stay in the department. It also differed with respect to patients’ behavioral intentions, answers to an overall satisfaction item, and open‐ended comments.
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Patrice François, Dominique Bertrand, Jose Labarere, Magali Fourny and Jean Calop
This paper aims to evaluate the effectiveness of a program designed to improve the quality of drug prescription‐writing at a university hospital in France. Improvement actions…
Abstract
This paper aims to evaluate the effectiveness of a program designed to improve the quality of drug prescription‐writing at a university hospital in France. Improvement actions included feed‐back from yearly audits and the dissemination of recommendations on how best to write the prescriptions. A random sample of 30 stays was selected from among the hospitalizations for the year 1996. From each patient, medical records were searched for the first prescription order of the stay and its quality was assessed according to standards. A total of 872 records were relevant and included 3,289 medications. The results were compared to those obtained for the two previous years. Actions to sensitize prescribers resulted in an insufficient improvement of most indicators of prescription‐writing quality with results remaining well below ideal standards. The hospital staff concerned had a positive opinion of the program which led to an awareness of prescription problems. This assessment showed that the program had a moderate impact on prescribers’ practice and efforts must be continued.
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José Labarère, Cécile Bos, Pierrick Bedouch, Magali Fourny, Patricia Pavese, Benoit Allenet and Patrice François
The aim of this study was to assess whether clinical guidelines complied with the instructions for writing structured care management tools in a French university hospital. A…
Abstract
The aim of this study was to assess whether clinical guidelines complied with the instructions for writing structured care management tools in a French university hospital. A cross‐sectional study of guidelines for appropriate antimicrobial agent use in the authors’ institution was carried out. A total of 221 guidelines were retrieved in 62 hospital units. The number of guidelines by unit ranged from one to 22 and 198 guidelines (90 per cent) had been developed at the local level. None of the guidelines fully complied with the ten criteria of the instructions. Each guideline met, on average, 4.2 criteria (3.9‐4.5). The partial compliance rate was 75 per cent (68‐80). In two‐level multivariate analysis, factors associated with partial compliance were: dissemination of guidelines after implementation of the instructions (odds ratio=6.25 (2.41‐16.21)), existence of more than one storage site for guidelines in each unit (OR=3.26 (1.03‐10.32)), and hospital unit (variance of the intercept=1.54).
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Laurent Boyer, Patrice François, Magali Fourny, Céline Ohrond, Charles Chanut, José Labarère and Pascal Auquier
The purpose of this paper is to assess the impact of five type II diabetes managed care programmes (MCPs) in clinical and economic terms at the community level in which these…
Abstract
Purpose
The purpose of this paper is to assess the impact of five type II diabetes managed care programmes (MCPs) in clinical and economic terms at the community level in which these programmes function in the Provence‐Alpes‐Côte d'Azur region of France.
Design/methodology/approach
A prospective, controlled, before‐and‐after study (2001‐2004) compared diabetic patients who lived in departments (localities) with (the experimental group) and without a MCP (the control group). Quality of care was estimated by the conformity of health care professionals' practices when following‐up type II diabetes. Costs are compared from a health service perspective.
Findings
The study finds that of 626 patients enrolled, 529 lived in departments with an MCP and 97 patients in departments without. Type II diabetes follow‐up globally improved between the two study periods (2001 and 2004), but the study did not show significant differences between the two groups, except for the proportion of creatinine and ophthalmologic examinations, which were higher for the control group. The study did not find significant differences in the increase of costs between the two groups from 2001 to 2004.
Research limitations/implications
This type of study could constitute a methodological model to assess the MCP's population impact.
Practical implications
MCPs probably did not reach a critical size in terms of patient recruitment and healthcare professional adhesion to have a significant impact at a population level.
Originality/value
The study highlights a number of points to consider for future MCPs in France.
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