Paciento sveikatos priežiūros (ligoninės) pasirinkimas ir kokybė: literatūros apžvalga ir atvejo (Lietuva) analizė

LTDarbo tikslas: išanalizuoti ir įvertinti paciento sveikatos priežiūros (ligoninės) pasirinkimo galimybę, šiam procesui įtakos turinčius veiksnius bei jų sąsajas su kokybe ekonomiškai išsivysčiusiose šalyse ir Lietuvoje. Analizuota įvairių šalių mokslinės publikacijos, nagrinėjančios sveikatos priežiūros įstaigų (ligoninių) pasirinkimą, teisės aktai, statistiniai duomenys, pacientų apklausos anketos. Medžiaga sisteminta ir vertinta. Darbe pateikta pacientų pasirinkimo koncepcija, atskleistas šio proceso sudėtingumas ir jį apsprendžiantys ar paveikūs veiksniai. Pateikta trumpa pacientų pasirinkimo Lietuvoje ir ligoninėje analizė. Daroma išvada, kad ligoninės pasirinkimas yra sudėtingas procesas, sąlygojamas įvairių veiksnių, organizacijos bei paciento charakteristikų, teigiamai veikiantis sveikatos priežiūros kokybę. [Iš leidinio]Reikšminiai žodžiai: Ligoninės charakteristikos; Ligoninės charakteritikos; Ligoninės pasirinkimas; Paciento charakteristikos; Sveikatos priežiūros kokybė; Health care quality; Hospital characteristics; Hospital choice; Patients characteristics.

ENThe aim of the study – to analyze and estimate the possibility of health care (hospital) choice, factors affecting this process and their relationship with quality in economically developed countries and in Lithuania. The object of the study and methods. The object of the study - process of the hospital choice. Methods – systematic analysis of scientific literature, interpretation and extrapolation of tendencies, statistical data analysis, theoretical generalization. A comparative analysis of patients questionnaires was performed, 175374 patients who were hospitalized in Klaipeda university hospital 2013-2017 years were interviewed (response rate 79,9%). Statistical data analysis was done using programme SP SS 20.0.1 for Windows. Results. It has been established that the theory of choice of health care is constantly changing, its application and results depend on the country’s structure of health care system, society and many other variables. The choice of patients health care has a positive impact on health care quality in hospitals, although it is a controversial statement. Both patient and hospital characteristics play an important role in choosing the hospitals. Patients in Lithuania have the right to choose a hospital and doctors since 1991. When examining the opinion of patients in the Klaipeda university hospitals, if was found that 80,5 proc. of then choose the hospital themselves, the rest were delivered to the hospital on an urgent basis, so they did not have a free choice. The absolute majority of patients were satisfied the health care in the hospital and will be chosen if in the future. Conclusions. The hospital’s choice is a complex process, a combination of patient hospital characteristics and behavior interaction in the context of a constantly changing environment.One of the factors contributing to health care quality improvement is the choice of the hospital which determines the patient’s active participation in the health care process and satisfaction. The patients personal characteristics and behavior influenced by experience, knowledge and information, greatly influence the choice of the hospital. Hospital’s characteristics – their structure, technologies, management, activity, quality and outcomes comparison of individual hospitals and exclusion of advantages – the main determinant of patient choice. The choice of hospital in Lithuania is a real possibility. A multidisciplinary, university, equipped with modern technologies, promoting high – quality hospital services – a subject of choice of patients, reflecting their needs and expectations, providing satisfaction with health care. [From the publication]

• Covid-19 pandemijos įtaka slaugos kokybei ligoninėje: sisteminė literatūros apžvaga ir pacientų nuomonė / Vinsas Janušonis, Gaivilė Kasap. Sveikatos mokslai 2023, t. 33, Nr. 5, p. 44-54.
• Rizikos valdymas sveikatos priežiūros organizacijose: sisteminė teorinė-praktinė apžvalga / Vinsas Janušonis. Klaipėda : S. Jokužio leidykla-spaustuvė, 2016. 287 p.