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Quality of care from patients' perspective: impact of the combination of person-related and external objective care conditions.

AIMS AND OBJECTIVES
To describe patients' perceptions of quality of care and to explore combinations of person-related and external objective care conditions as potential predictors of these perceptions.


BACKGROUND
Several studies have examined various single factors of person-related and external objective care conditions in relation to quality of care. None of these has included the effect of over-occupancy on patients' perception of quality of care. Furthermore, little is known about how combinations of different factors are related to each other and to the perception of quality of care using multivariate analysis.


DESIGN
A cross-sectional design.


METHOD
A total of 528 patients (83·7%) from 12 medical, surgical or medical-surgical wards in five hospitals in Norway participated. Perceptions of quality of care and person-related conditions were measured with the 'Quality from Patient's Perspective' instrument. Data on external objective care conditions was collected from ward statistics provided by head nurses. Multivariate general linear modelling was used (p < 0·05).


RESULTS
The combination of person-related and external objective care conditions revealed five factors that predict patients' perception of quality of care. Three of these are person-related conditions: sex, age and self-reported psychological well-being and two of them are external objective care conditions: RNs (headcount) on the wards and frequency of over-occupancy. These five factors explained 55% of the model. Patients rated the quality of care high.


CONCLUSIONS
Sex, age, psychological well-being, frequency of over-occupancy and the number of RNs are important factors that must be emphasised if patients are to perceive the quality of care as high. Relevance to clinical practice.  Head nurses and healthcare authorities must continually prepare the wards for over-occupancy and they must consider the number of RNs working on the wards.