Exploring the dimensions of patient experience for community-based care programmes in a multi-ethnic Asian context

PLoS One. 2020 Nov 25;15(11):e0242610. doi: 10.1371/journal.pone.0242610. eCollection 2020.

Abstract

Introduction: The aim of this study is to explore patients' experiences with community-based care programmes (CCPs) and develop dimensions of patient experience salient to community-based care in Singapore. Most countries like Singapore are transforming its healthcare system from a hospital-centric model to a person-centered community-based care model to better manage the increasing chronic disease burden resulting from an ageing population. It is thus critical to understand the impact of hospital to community transitions from the patients' perspective. The exploration of patient experience will guide the development of an instrument for the evaluation of CCPs for quality improvement purposes.

Methods: A qualitative exploratory study was conducted where face-to-face in-depth interviews were conducted using a purposive sampling method with patients enrolled in CCPs. In total, 64 participants aged between 41 to 94 years were recruited. A deductive framework was developed using the Picker Patient Experience instrument to guide our analysis. Inductive coding was also conducted which resulted in emergence of new themes.

Results: Our findings highlighted eight key themes of patient experience: i) ensuring care continuity, ii) involvement of family, iii) access to emotional support, vi) ensuring physical comfort, v) coordination of services between providers, vi) providing patient education, vii) importance of respect for patients, and viii) healthcare financing.

Conclusion: Our results demonstrated that patient experience is multi-faceted, and dimensions of patient experience vary according to healthcare settings. As most patient experience frameworks were developed based on a single care setting in western populations, our findings can inform the development of a culturally relevant instrument to measure patient experience of community-based care for a multi-ethnic Asian context.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Asia / ethnology
  • Community Networks*
  • Delivery of Health Care*
  • Ethnicity*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Patient Participation*
  • Qualitative Research

Grants and funding

This work was supported by an internal grant from the NUHS Research Office (https://www.nuhs.edu.sg/research/Pages/about-NUHS-research-office.aspx) (grant number NUHSRO/2016/008/RO5+5/FY16CF/LOA), the Centre for Health Services and Policy Research (CHSPR) core funding (which funded MN), the Singapore Ministry of Health’s National Medical Research Council Centre Grant Programme (https://www.nmrc.gov.sg/grants/competitive-research-grants) (grant number NMRC/CG/C026/2017_NUHS) for Singapore Population Health Improvement Centre (SPHERiC) (which funded IA, FS, PS, KXE and ST) and Health Service Research Grant (HSRG) (grant number NMRC/HSRG/0086/2018) (which funded CDF). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.