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Background: Often preventive measures are not accessed by the people who were intended to be reached. Programs for older adults may target men and women, older adults, advanced old age groups and/or chronically ill patients with specific indications. The defined target groups rarely participate in the conception of programs or in the design of information materials, although this would increase accessibility and participation. In the German “Reaching the Elderly” study (2008–2011), an approach to motivating older adults to participate in a preventive home visit (PHV) program was modified with the participatory involvement of the target groups. The study examines how older men and women would prefer to be addressed for health and prevention programs.
Methods: Four focus groups (N = 42 participants) and 12 personal interviews were conducted (women and men in 2 age groups: 65–75 years and ≥ 76 years). Participants from two districts of a major German city were selected from a stratified random sample (N = 200) based on routine data from a local health insurance fund. The study focused on the participants’ knowledge about health and disease prevention and how they preferred to be approached and addressed. Videos of the focus groups were recorded and analysed using mind mapping techniques. Interviews were digitally recorded, transcribed verbatim and subjected to qualitative content analysis.
Results: A gender-specific approach profile was observed. Men were more likely to favor competitive and exerciseoriented activities, and they associated healthy aging with mobility and physical activity. Women, on the other hand, displayed a broader understanding of healthy aging, which included physical activity as only one aspect as well as a healthy diet, relaxation/wellness, memory training and independent living; they preferred holistic and socially oriented services that were not performance-oriented. The “older seniors” (76+) were ambivalent towards
certain wordings referring to aging.
Conclusions: Our results suggest that gender-specific needs must be considered in order to motivate older adults to participate in preventive services. Age-specific characteristics seem to be less relevant. It is more important to pay attention to factors that vary according to the individual state of health and life situation of
the potential participants.
Hintergrund:
Feedback von Patienten über erlebte Versorgungsaspekte erfolgt auch in der Rehabilitation inzwischen zunehmend online, beispielsweise auf Bewertungsportalen. Daher soll untersucht werden, welche von Rehabilitanden auf der für Reha-Kliniken führenden Bewertungsplattform Klinikbewertungen.de veröffentlichten Versorgungsaspekte mit der Weiterempfehlung einer Rehaklinik und welche negativen Aspekte mit der Nicht-Weiterempfehlung assoziiert sind.
Methode:
Eingeschlossen wurden Reha-Kliniken der Rentenversicherung Bund und federführend von ihr belegte Kliniken. Mit einem Mixed-Methods-Ansatz wurden aus acht Reha-Indikationsgruppen nach Zufriedenheitsstufen stratifizierte freitextliche Erfahrungsberichte von Rehabilitanden inhaltsanalytisch ausgewertet. Der Zusammenhang zwischen positiven (negativen) Aussagen mit der (Nicht-)Weiterempfehlung wurde in der jeweiligen Reha-Indikationsgruppe untersucht.
Ergebnisse:
Die Inhaltsanalyse von 911 Erfahrungsberichten ergab 20 thematische Kategorien. Der von Rehabilitanden wahrgenommene "Reha-Erfolg" war am häufigsten mit der Weiterempfehlung bzw. Nicht-Weiterempfehlung signifikant assoziiert. In fünf QS-Vergleichsgruppen war das Thema "Verpflegung" assoziiert. In allen QS-Vergleichsgruppen war mindestens ein prozessorientiertes Rehabilitationsthema assoziiert: "Reha-Maßnahmen", "Reha-Plan und Reha-Ziele" und/oder "Diagnose bis Entlassung".
Diskussion und Schlussfolgerung:
Reha-Kliniken können auf Basis der vorgestellten Ergebnisse indikationsspezifisch die für die Klinik-Weiterempfehlung relevanten Versorgungsaspekte identifizieren. Die Einbeziehung von Online-Erfahrungsberichten schafft zusätzliche Erkenntnisse über die Gründe der (Un-)Zufriedenheit von Rehabilitanden. Potenziellen Rehabilitanden steht das Erfahrungswissen als niederschwellige Informationsquelle und Entscheidungshilfe zur Verfügung
We present a simple method to find topics in user reviews that accompany ratings for products or services. Standard topic analysis will perform sub-optimal on such data since the word distributions in the documents are not only determined by the topics but by the sentiment as well. We reduce the influence of the sentiment on the topic selection by adding two explicit topics, representing positive and negative sentiment. We evaluate the proposed method on a set of over 15,000 hospital reviews. We show that the proposed method, Latent Semantic Analysis with explicit word features, finds topics with a much smaller bias for sentiments than other similar methods.
Purpose: The calculation of aggregated composite measures is a widely used strategy to reduce the amount of data on hospital report cards. Therefore, this study aims to elicit and compare preferences of both patients as well as referring physicians regarding publicly available hospital quality information.
Methods: Based on systematic literature reviews as well as qualitative analysis, two discrete choice experiments (DCEs) were applied to elicit patients’ and referring physicians’ preferences. The DCEs were conducted using a fractional factorial design. Statistical data analysis was performed using multinomial logit models.
Results: Apart from five identical attributes, one specific attribute was identified for each study group, respectively. Overall, 322 patients (mean age 68.99) and 187 referring physicians (mean age 53.60) were included. Our models displayed significant coefficients for all attributes (p < 0.001 each). Among patients, “Postoperative complication rate” (20.6%; level range of 1.164) was rated highest, followed by “Mobility at hospital discharge” (19.9%; level range of 1.127), and ‘‘The number of cases treated” (18.5%; level range of 1.045). In contrast, referring physicians valued most the ‘‘One-year revision surgery rate’’ (30.4%; level range of 1.989), followed by “The number of cases treated” (21.0%; level range of 1.372), and “Postoperative complication rate” (17.2%; level range of 1.123).
Conclusion: We determined considerable differences between both study groups when calculating the relative value of publicly available hospital quality information. This may have an impact when calculating aggregated composite measures based on consumer-based weighting.
Purpose: This study aims to determine the intention to use hospital report cards (HRCs) for hospital referral purposes in the presence or absence of patient-reported outcomes (PROs) as well as to explore the relevance of publicly available hospital performance information from the perspective of referring physicians.
Methods: We identified the most relevant information for hospital referral purposes based on a literature review and qualitative research. Primary survey data were collected (May–June 2021) on a sample of 591 referring orthopedists in Germany and analyzed using structural equation modeling. Participating orthopedists were recruited using a sequential mixed-mode strategy and randomly allocated to work with HRCs in the presence (intervention) or absence (control) of PROs.
Results: Overall, 420 orthopedists (mean age 53.48, SD 8.04) were included in the analysis. The presence of PROs on HRCs was not associated with an increased intention to use HRCs (p = 0.316). Performance expectancy was shown to be the most important determinant for using HRCs (path coefficient: 0.387, p < .001). However, referring physicians have doubts as to whether HRCs can help them. We identified “complication rate” and “the number of cases treated” as most important for the hospital referral decision making; PROs were rated slightly less important.
Conclusions: This study underpins the purpose of HRCs, namely to support referring physicians in searching for a hospital. Nevertheless, only a minority would support the use of HRCs for the next hospital search in its current form. We showed that presenting relevant information on HRCs did not increase their use intention.