Quality of integrated care for patients with multimorbidity in China: a Servqual Model analysis
摘要
Global ageing is a serious concern, and the number of patients with multimorbidity is continuously increasing. Patients receive fragmented health services in a multispecialty and multidepartmental model without access to continuous and coordinated integrated care, resulting in unsatisfactory patient experiences. From the patient’s perspective, we measured the quality of integrated care and proposed strategies to improve the accessibility for patients with multimorbidity.
MethodsThe survey combined the importance-performance analysis method and Servqual Model to measure the quality of integrated care for patients with multimorbidity and the mechanisms of action of related influencing factors.
ResultsThe quality scores for each dimension were as follows: patient-centeredness (0.44) > synergy of intra-team services (-0.37) > continuity of services (-1.54) > synergy of inter-team services (-1.94) > familiarity with the patient’s medical history and treatment (-2.66). Positive/negative scores denote perceived quality above/below patients’ expectations. Notably, SERVQUAL scores were positive only for patient-centredness, while all dimensions assessing service integration and continuity of care were negative, indicating that patients do not perceive the care as truly integrated.
ConclusionPatients perceive significant gaps in multimorbidity care continuity and coordination, despite strong patient-centeredness. We propose three evidence-based interventions to address priority gaps: shared medication summaries, standardized electronic discharge summaries, and pharmacist-supported medication reconciliation.