Establishing the Criteria for the Quality of Elderly Medical Care From the Multiple Perspectives

Establishing the Criteria for the Quality of Elderly Medical Care From the Multiple Perspectives

Wan-I Lee (National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan), Chun-Chi Chen (College of Management, Ph. D. Program, National Kaohsiung University of Science and Technology, Kaohsiung, Taiwan) and Yu-Bin Huang (Department of Healthcare Administration, E-DA Cancer Hospital, Kaohsiung, Taiwan)
DOI: 10.4018/IJCRMM.2018100103

Abstract

In 1993, Taiwan has transformed into an aged society. Compared with general patients, older patients differ considerably in body functionality, mentally, and mobility-wise. The primary customers of medical institutions are adult patients in Taiwan, and the needs of older patients are often ignored; however, older patients visiting the case hospital in this study accounted for nearly 30% of the total number of outpatients. This indicates that the needs of older patients are a matter requiring the serious attention of medical personnel. This is a common issue for all countries that were entered an aging structure of the population. This study investigated the attention paid by supervisors and medical personnel involved with medical decisions to the quality of medical services received by older outpatients. An analytic hierarchy process (AHP) was employed to interview 10 experts in older medical care providing age-friendly medical care at the case hospital, medical staff including senior physicians, nursing department supervisors, administration department supervisors, and certified managers. The results indicate that the supervisors and medical personnel considered the “communication and services” provided to older patients during their medical treatments to be the most crucial factor in their treatment process, rating it twice as important as the next most important criteria, the care process and physical environment. Medical personnel paid great attention to communicate with and servicing older patients; listening to their needs and concerns was deemed the most critical, followed by being able to empathize with them to solve problems. Asking patients about their problems when they visited the hospital was considered the most crucial aspect of the care process; in the physical environment, it was spatial planning and traffic flow design. The results of this study enable other countries' medical institution managers and relevant competent authorities to gain insight into the attention paid by front-line employees in promoting age-friendly medical care. If supervisors and medical personnel involved with medical decisions share a similar attitude toward promoting medical service quality, government authorities and medical institutions can implement and enhance an age-friendly medical treatment environment for older patients, as well as increase quality of patient-centered medical services.
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Literature Review

Medical Service Quality

Donabedian (1988) argued that the quality of medical services provided by hospitals is determined by medical institutions after considering patients’ health and the institutional decision-makers’ responsibilities to maintain patients’ health and provide effective care. Medical care comprises two aspects: medical technology and patient–medical personnel relationships and interactions (Donabedian, 1979). Quality management must account for the expected profits and risks of the provided medical care, which must be legal, meet patients’ expectations, and conform to social and professional standards.

According to Mosadeghrad (2012), health care quality covers the aspects of a clean and tidy environment, patient safety, efficacy, effectiveness, efficiency, empathy, medical services, medical technology, care resources, services provided by the medical institution to the patient, and the professional image of the medical institution. Chilgren (2008) maintained that medical service quality entails patient satisfaction management and that efforts made by medical institutions to elevate medical service quality are the key to their success, as well as the core value facilitating their outstanding performance. Favorable medical service quality is achieved only when each interaction with patients is favorable. Mosadeghrad (2013a) found that medical services should follow clinical guidelines and standards to provide effective care, efficiently achieve patient satisfaction, meet patient needs, and facilitate patient well-being. In this study, medical service quality was treated as the basic drive supervisors and medical personnel involved with medical decisions to promote age-friendly medical care.

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