The use of the multiattribute utility theory to measure the stability of patients' quality judgments

Abstract

Neste artigo, o autor pretende descrever uma investigação levada a cabo para saber se as opiniões dos doentes sobre a qualidade dos cuidados hospitalares dependem do momento em que são emitidas. Para conhecer essas opiniões, mediu-se a satisfação, utilizando escalas do tipo Likert, e as expectativas ao longo do tempo, através da aplicação da teoria multi-atributo de utilidade. Para este trabalho de investigação, seleccionaram- se, em nove hospitais, doentes diagnosticados com enfarte do miocárdio. Com o auxílio de questionários, coligiram-se dados referentes às respostas de 164 doentes, um mês e cinco meses após a alta. Os resultados mostraram que, pelo menos nos casos de enfarte do miocárdio, a satisfação e as expectativas dos doentes não são necessariamente estáveis no tempo. Conclui-se que o momento da fase de recuperação em que as avaliações são pedidas é um elemento fundamental.

Dans cet article, l’auteur se propose de décrire une recherche qui été menée dans l’objectif de déterminer si les évaluations faites par les malades sur la qualité des soins hospitaliers dépendent du moment où elles sont émises. Pour connaître ces évaluations, on a mesuré le degré de satisfaction à l’aide d’échelles de Likert, et les expectatives au long du temps à l’aide de l’application de la théorie des multi-attributs de l’utilité. Pour ce travail de recherche, on a sélectionné dans neuf hôpitaux, des malades souffrant d’infarctus du myocarde. A l’aide de questionnaires, on a recueilli les données référentes aux réponses de cent soixantequatre malades, un mois, puis cinq mois après leur autorisation de sortie de l’hôpital. Les résultats démontrent que, tout au moins dans le cas d’infarctus du myocarde, la satisfaction et les expectatives des malades ne sont pas nécéssairement stables dans le temps. On en conclut que le moment de la phase de rétablissement où ces évaluations sont demandées est un élément fondamental.

The purpose of this paper is to describe a research carried out to determine whether patients’ judgments concerning quality of hospital care depend on when their judgments are assessed. To obtain patients’ judgments about quality of care the author measured their satisfaction, by using traditional Likert-type scales, as well as their expectations over time, using the multiattribute utility approach. The current research had a within-subject design and was diagnosis-specific. People diagnosed with myocardial infarction were selected from nine hospitals. Through self-administered questionnaires, data were collected from one hundred sixty-four patients at two points of time: one month and five months after discharge. Results showed that, at least for myocardial infarction, patients’ satisfaction and expectations are not necessarily stable over time. The time at which the assessment is administered during the patient’s recovery process is crucial.