Health Quality Council of Alberta Satisfaction and Experience with Health Care Services: A Survey of...

7/29/2019 Health Quality Council of Alberta Satisfaction and Experience with Health Care Services: A Survey of Albertans 2012

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LISTENING TO ALBERTANS

SATISFACTION AND EXPERIENCE WITH

HEALTHCARE SERVICES: A SURVEY OF

ALBERTANS 2012

JANUARY 2013

www.hqca.ca

PROMOTING AND IMPROVING PATIENT SAFETY AND HEALTH SERVICE QUALITY ACROSS ALBERTA

>

How does the HQCA define quality? In

2004, the HQCA developed the Alberta

Quality Matrix for Health, which defines six

dimensions of quality: acceptability,

accessibility, appropriateness, effectiveness,

efficiency and safety. All of these dimensions

focus on how our healthcare system should

deliver services. The HQCAs Satisfaction

and Experience with Healthcare Services survey

is an important tool for the HQCA to

assess how the health system is currently

performing in some of these key dimensions.

When assessing quality it is important to

gain the public/patient perspective on their

healthcare experience.This feedback paints

part of the overall picture for us as we strive

to fulfill our mandate to promote and improve

health service quality across Alberta.

You can find theAlberta Quality Matrix for

Health and more information atwww.hqca.ca.

PAVING THE WAY TO IMPROVED CARE

The Health Quality Council of Alberta (HQCA) has been conducting

population-based surveys on satisfaction and experience with the

healthcare system since 2003. The continuous monitoring of patient

experience is part of the HQCAs commitment to ongoing improvement

in the public health system in Alberta.

WHY ITS IMPORTANT TO HEAR FROM YOU

How Albertans feel about their healthcare experiences is an important

measure of what is working in Albertas health system and can also

help identify opportunities for improvement. This feedback provides

valuable information to Alberta Health, Alberta Health Services (AHS),

the health professions, healthcare providers and other stakeholders

responsible for healthcare service delivery.

The 2012 survey is of interest because it can be compared against

benchmark results from 2010, which was the first year we measured

patient satisfaction and experience since the formation of AHS.

WHO RESPONDED TO OUR SURVEY?

Our survey sampled 4,803 Albertans who were 18 years of age and

older, and had a land-line telephone. To ensure the respondents were

representative of Albertans, quotas were set for age and gender groupswithin each of the 5 Alberta Health Services zones. Some questions

were limited to only the respondents who had an experience with the

healthcare system in the previous 12 months. Survey weights were

used to make the results more representative of the population.

ALBERTAQUALITY MATRIXFOR HEALTH


2/12

LISTENING TO ALBERTANS www.hqca.ca

2

SOME OF THE KEY FINDINGS

Results of the 2012 survey remain relatively stable and comparable to the 2010 survey, and are a reflection

of Albertans experiences with healthcare services between February 24, 2011 and May 27, 2012.

64% of Albertans were satisfied with the healthcare services they received, compared to 62% in 2010.

Respondents in Alberta Health Services North zone were significantly less likely to be satisfied

with healthcare services (56%) as compared to the overall rating for Alberta (64%).

Albertans ingood health weremost likely to be satisfied with healthcare services received (71%),

and respondents considered the least healthy were lesslikely to be satisfied (56%) both ratings

differed significantly from the overall satisfaction rating of 64%.

The top three factors that influenced Albertans overall satisfaction rating were access to healthcare

services, quality of healthcare services, and how well healthcare professionals coordinate their efforts

to serve patient needs.

51% of Albertans rated access to healthcare services as easy, similar to 2010 (48%).

65% of Albertansbelieve the quality of healthcare services in the province is excellent or good, which

is the same as 2010 (65%). In comparison, 77% of respondents who actually received healthcare services

in Alberta in 2012 rated the quality of care as excellent or good, similar to 2010 (75%).

Less than 50% of respondents in 2012 rated how wellhealthcare professionals coordinated theirefforts to serve their needs as very good or excellent, which is unchanged since 2003. Healthy respondents

were more likely to report the healthcare professionals were excellent or very good at coordinating their

efforts (56%), compared to the least healthy respondents (44%).

54% of respondents who visited an emergency department in 2012 rated access to the emergency

department as easy the same result as 2010 (54%).

84% of respondents with apersonal family doctor were very satisfied with the healthcare services

they received from their doctor, similar to 2010 (83%).

13% of Albertans who received healthcare services in 2012 had a serious complaint unchanged

from 2010.

11% of Albertans said they or an immediate family member experienced unexpected harm within

Albertas healthcare system in 2012, significantly more than in 2010 (9%).

SATISFACTION AND EXPERIENCE WITH HEALTHCARE SERVICES: A SURVEY OF ALBERTANS 2012


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100

75

50

25

0

52% 58% 60% 62% 64%

2004 2006 2008 20122010

Overall satisfaction with healthcare services(4 or 5 out of 5)*

The vertical lines in the middle of each bar are confidence intervals that help gauge

statistically significant differences between numbers. Vertical lines that do not overlap

with each other mean differences are statistically significant. Overlapping lines indicate

no significant differences.

*4 or 5 out of 5 on a 5-point scale where 1 is very dissatisfied and 5 is very satisfied.

% SATISFIED (4 OR 5 OUT OF 5)**

HEALTHCARE SERVICE AREA

Family doctor

Community walk-in clinic

Emergency department

Specialist

Mental health

MRI (publicly funded)

Diagnostic imaging

Serious complaint handling

Satisfaction with specific healthcare services received

2010

83

58

59

79

78

85

87

20

2008

83

56

58

81

74

89

89

19

2006

84

57

51

81

72

79

88

24

2004

84

60

50

74

70

76

85

15

*

*

*

*

*

*Denotes statistically significant difference compared to the 2012 survey year. **4 or 5 out of 5 on a 5-point scale where 1 is very dissatisfied and 5 is very satisfied.

2012

84

62

59

80

74

82

89

20

WE ASKED ALBERTANS ABOUT

OVERALL SATISFACTIONThinking about all of your personal experiences within the

past year with the healthcare services in Alberta that we just

reviewed, to what degree are you satisfied or dissatisfied with

the services you have received?

SATISFACTION WITH HEALTHCARE SERVICES RECEIVED

64% of Albertans were satisfied with the healthcare services they received in 2012. This is relatively unchanged

from 2010 (62%), and a significant improvement from 2008 (60%) and 2006 (58%).

Q


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1. ACCESS TO HEALTHCARE SERVICES

Access to healthcare services is the most important factor

that influences Albertans rating of overall satisfaction with

healthcare services received. The easier the access, the more

satisfied Albertans are with their healthcare experience.

Thinking of access and waiting times overall, how difficult or

easy was it to actually obtain the healthcare services you neededin Alberta within the past year?

WHAT WE HEARD

Just over half (51%) of Albertans rated overall access to

healthcare services as easy in 2012. This is relatively

unchanged from 2010 (48%) and is significantly higher

than 2008 (46%) and all other previous years.

The factor that was most important to Albertans concerning

ease of access was access to their personal family doctor.

Other factors associated with ease of access to healthcare

services include:

Ease of access to emergency department services

Ease of access to specialists

Ease of access to walk-in clinics

% EASY ACCESS (4 OR 5 OUT OF 5)**


Family doctor



Specialist

Mental health

MRI (publicly funded)

Diagnostic imaging

Ease of access to specific healthcare services

2010

72

56

54

62

78

58

80

2008

73

53

51

59

79

59

79

2006

74

60

48

56

74

56

92

2004

NA

60

50

47

66

51

89

*Denotes statistically significant difference compared to the 2012 survey year. **4 or 5 out of 5 on a 5-point scale where 1 is very difficult and 5 is very easy.

*

**

*

*

*

*

*

2012

76

58

54

64

78

61

83

WHAT ARE THE TOP 5 FACTORS THAT INFLUENCE ALBERTANS RATING OFOVERALL SATISFACTION?

1. Access to healthcare services 2. Quality of healthcare services 3. Coordination of care4. Satisfaction with emergency department services 5. Satisfaction with handling of serious complaints

100

75

50

25

0

Overall ease of access to healthcare services(4 or 5 out of 5)*



with each other mean differences are statistically significant. Overlapping lines

indicate no significant differences.

*4 or 5 out of 5 on a 5-point scale where 1 is very difficult and 5 is very easy.

42% 46% 47% 46% 48% 51%

20042003 2006 2008 20122010

Q


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5PROMOTING AND IMPROVING PATIENT SAFETY AND HEALTH SERVICE QUALITY ACROSS ALBERTA

Q

Q

2. QUALITY OF HEALTHCARE SERVICES

Quality of healthcare services is the second most important

factor that influences Albertans rating of overall satisfaction

with healthcare services received. If respondents rated

quality as excellent or good, they were more likely to be

satisfied with their heathcare experience.

Thinking about all of your personal experiences within

the past year with the healthcare services in Alberta that we

just reviewed, how would you describe the overall quality of

those services?

WHAT WE HEARD

65% of Albertans believe the quality of healthcare services

in Alberta is excellent or good. The rating increases to 77%

among those who actually received services in the past year.

Two factors with the greatest influence on respondents

rating of quality were the coordination of healthcare

professionals efforts and whether or not the respondent

had a serious complaint.

Other factors that influenced overall quality ratings:

Quality of care received from their personal family

doctor

Quality of emergency department services

Quality of care received from their walk-in clinic doctor

Quality of care received from a specialist

3. COORDINATION OF CARE

The third most important factor influencing Albertans

overall satisfaction rating with healthcare services received

is coordination of care.

Thinking about the healthcare services you received in

Alberta in the past year, how would you describe how well

all the healthcare professionals coordinated their efforts to

serve your needs?

WHAT WE HEARD

Less than 50% of respondents in 2012 rated how well

healthcare professionals coordinated their efforts toserve their needs as very good or excellent, which is

unchanged since 2003.

95% of respondents reported that in the past year,

there was never a time that doctors ordered a medical

test that they felt was unnecessary because the test

had already been done. This was a new survey question

in 2012.



with each other mean differences are statistically significant. Overlapping lines

indicate no significant differences.

100

75

50

25

0

74% 73% 75% 77%

2006 2008 20122010

Quality of received healthcare services(% good or excellent)

% EXCELLENT OR VERY GOOD


Family doctor



Specialist

Quality of specific healthcare services received

2010

75

40

50

71

2012

71

43

51

70


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6

100

75

50

25

0

2006

Respondents were asked whether their family doctor had been informed about treatment, care or tests they hadreceived elsewhere in the system.

2008 2010 2012

EMERGENCY DEPARTMENT SPECIALIST MRI HOSPITAL CAREDIAGNOSTIC IMAGING

3. COORDINATION OF CARE - CONTINUED

PERCENTAGEWHOSTATED

THATDOCTORSWEREINFORMED

48%50%51%49%

64%65%63%64%

85%88%87%90%88%86%85%83%

68%66%68%69%

Q

100

75

50

25

0

Percent of respondents who went to the emergency department instead of somewhere else, by reason and survey year

2008

2010

2012

... THE ONLY CHOICE

AVAILABLE AT THE TIME

52%

55%

57%

... THE MOST CONVENIENT

PLACE TO GO

20%

27%

25%

... THE BEST PLACE FOR MY

MEDICAL PROBLEM

35%

37%

37%

... I WAS TOLD TO GO TO

THE EMERGENCY DEPARTMENT

20%

21%

19%

OTHER SPECIFIED

5%

1%

10%

4. SATISFACTION WITH EMERGENCY DEPARTMENT SERVICES

Satisfaction with emergency department services was the fourth most important factor influencing respondents overall

satisfaction rating.

How satisfied are you with emergency department services you or your family member most recently received?

WHAT WE HEARD

The percentage of respondents who were satisfied (4 or 5 out of 5) with emergency department services in 2012

(59%) has not changed since 2008 and 2010 (59%), but is significantly higher than in 2006 (51%), 2004 (50%) and

2003 (50%).

The percentage of respondents who rated access to emergency department services as easy (4 or 5 out of 5) is

unchanged from 2010 (54%).

The percentage of respondents who said they had gone to the emergency department instead of somewhere else

because it was the only choice available at the time (57%) is relatively unchanged from 2010 (55%).

PERCEN

TAGE


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7


100

75

50

25

0

2006

Respondents satisfaction with how their complaint was handled, by survey year

2008

2003

2004

2010

2012

5 VERY SATISFIED

9%

6%

8%

10%

10%

8%

4

12%

9%

16%

9%

10%

12%

3

19%

22%

19%

20%

19%

13%

1 VERY DISSATISFIED

41%

47%

35%

43%

40%

50%

2

20%

16%

23%

19%

21%

17%

PERCENTAGE

5. SATISFACTION WITH HANDLING OF SERIOUS COMPLAINTS

Satisfaction with handling of patient complaints was the fifth most important factor influencing respondents overall

satisfaction rating.

To what extent were you satisfied or dissatisfied with how your complaint was handled and addressed?

WHAT WE HEARD

13% of Albertans who received healthcare services had a serious complaint, unchanged from 2010.

Of the respondents who had a serious complaint, 43% did not report their complaint, and 41% voiced their complaint

directly to a healthcare professional. These results are relatively unchanged from previous years.

67% of respondents who had a serious complaint were dissatisfied (1 or 2 out of 5) with how their complaint

was handled, which is relatively unchanged from 2010 and 2008 (61%).

Q


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MORE FINDINGS

Family Doctors

The majority of respondents who do not have a

family doctor use community walk-in clinics (55%)

and 7% say they use the emergency department.

33% of respondents who had visited their family

doctor in the previous year said that they needed

their doctors help in making changes to prevent

illness, and of those respondents, 91% indicated

that their doctor gave them the help they needed. 55% of respondents had talked with their family

doctor in the previous year about their exercise and

physical activity. This result is relatively unchanged

from 2010 (54%).

46% of respondents said they had talked to their

family doctor in the previous year about their diet

and eating habits. This result is relatively unchanged

from 2010 (45%).

Patient Safety

When asked about experiences of unexpected harm,

11% of respondents reported that they or an

immediate family member experienced harm while

receiving healthcare sometime in the past year,

which is significantly more than 2010 (9%) but

significantly less than 2003, 2004 and 2006.

Health Link

Albertans awareness of Health Link has increased

over time, rising from 66% in 2006 to 79% in 2012.

78% of Albertans who used Health Link in the past

year were satisfied (4 or 5 out of 5) with Health Link,

a significant increase from 2010 (72%).

At 83% in 2012, the number of Albertans who have a

family doctor has remained relatively unchanged since

the first survey in 2003 (81%).

100

75

50

25

0

Respondents who currently have a family doctor

81% 85% 81% 81% 82% 83%

20042003 2006 2008 20122010

100

75

50

25

0

Percent of respondents who indicated that they or an

immediate family member experienced unexpectedharm while receiving healthcare in Alberta


statistically significant differences between numbers. Vertical lines that do not

overlap with each other mean differences are statistically significant. Overlapping

lines indicate no significant differences.

14% 13% 13% 10% 9% 11%

20042003 2006 2008 20122010


9/12

The majority of respondents who received mental health services

in the past year said they obtained the services at a private counsellor/

therapist office (33%). Mental health services were also obtained

at a family doctor's office (23%), mental health clinic (15%) or

hospital (15%). These results are relatively similar to 2008 and 2010.

Hospital Care

84% of respondents rated the quality of their inpatient care duringan overnight hospital stay as excellent or good, which is relatively

unchanged from 2010 (79%). Only 2% rated the quality as poor,

which is significantly less than 2010 (10%).

85% of respondents rated the quality of their daytime outpatient

hospital care as excellent or good, which is relatively unchanged

from 2010 (86%).

Diagnostic Imaging

12% of respondents indicated that they had received magnetic

resonance imaging (MRI) services, which is unchanged from 2010

and 2008, but a significant increase from 2006 (8%) and 2004 (6%).

Among respondents who received a private MRI (7%), 87% agreed

they went to the private sector because the funded MRI wait time

was too long, which is unchanged from 2010.

The proportion of respondents who received some form of diagnostic

imaging other than an MRI in the past year (42%) is relatively

unchanged from 2010 (41%).

100

75

50

25

0

Percent of respondents who received mental health services in specific locations, by survey year.

2008 2010 2012

HOSPITAL EMERGENCY

DEPARTMENT

MENTAL HEALTH

CLINIC

FAMILY DOCTORS

OFFICE

OTHER SPECIFIEDTELEMENTAL

HEALTH

PRIVATE COUNSELLOR/

THERAPIST OFFICE

10%12%15%

0%1%2%

14%17%15%

31%24%23%

0%1%1%

8%11%12%

37%33%33%

Mental Health


9



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10

COMPARISON: HEALTH STATUS AND PATIENT EXPERIENCE

Our survey results were analyzed by Albertans self-reported health status to compare the experience

of those categorized as less healthy to those categorized to be in good health. The respondents state of

health greatly influenced how they rated their experience.

Satisfaction Albertans in good health were more likely to be satisfied with healthcare services received (71%); respondents who

were the least healthy were less likely to be satisfied (56%). Both ratings differed significantly from Albertans

overall satisfaction rating of 64%.

Access

Overall, just over half (51%) of Albertans rated access to healthcare services as easy. This rating increased to 57%

among healthiest respondents and decreased to 42% among those who are least healthy.

Quality of Care

When Albertans were asked to rate the quality of healthcare services they received in 2012, 77% reported it was

good or excellent. This number increased to 81% among the healthy group. Results from the least healthy category

were below the provincial rating at 71%.Coordination of Care

While less than half (49%) of Albertans rated how well healthcare professionals coordinated their efforts to serve their

needs as good or excellent, this number increased significantly to 56% among the most healthy and decreased to 44%

among the least healthy.

Serious Complaints

The least healthy category of respondents were the most likely to have a serious complaint about healthcare services

(16%) compared to the healthiest group (11%).

MORE FINDINGS continued

Pharmacist ServicesSeveral new questions were added to the 2012 survey in relation to medication use and pharmacy services.

73% of respondents who were taking on average, two different prescribed medications on a regular basis,

reviewed and discussed the different medicines they were taking with a pharmacist or doctor during the past year.

41% of respondents do not have a written list of all the medications they are currently taking.

20% of respondents had difficulty filling a prescription for their medicine because a pharmacy did not have

enough medicine or the right medicine.

Public Health

28% of Albertans have never had a flu shot. The North zone has significantly more respondents who have never

had a flu shot (38%) compared to the Edmonton (27%), Central (31%), Calgary (26%), and South (26%) zones.

The most common reason respondents reported that they did not have a flu shot in the past year is because they

did not think it was necessary (47%), followed by they had not gotten around to it (21%). Other reasons were

because they had a bad reaction to a previous shot (10%) or they were fearful (3%).


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RESULTS BY ALBERTA HEALTH SERVICES ZONES

2012 Satisfaction, access and quality ratings across Alberta Health Services zones and by healthcare service area

EMERGENCY FAMILY WALK-IN DIAGNOSTICDEPARTMENT DOCTOR CLINIC SPECIALIST MRI IMAGING

ALBERTA

SOUTH

ZONE

CALGARY

ZONE

CENTRAL

ZONE

EDMONTON

ZONE

NORTH

ZONE

Satisfaction % satisfied

Access % easy access

Quality % excellent/very good
















59

54

50

63

58

53

61

54

53

60

59

54

55

49

46

59

49

44

84

76

71

87

80

72

84

78

70

82

68

70

86

80

73

80

64

66

62

58

43

65

62

47

64

57

43

73

65

51

56

56

40

63

60

44

80

64

70

78

66

73

83

63

70

80

62

71

78

65

69

77

66

66

82

61

84

66

80

61

88

58

83

59

82

63

89

83

89

84

89

83

87

85

89

85

87

74

Note: Differences may not be statistically significant. See Technical Report for details.

2012 Overall satisfaction, access and quality scores by Alberta Health Services zones

OVERALL OVERALL OVERALLSATISFACTION % ACCESS % QUALITY %

(4 OR 5 OUT OF 5)* (4 OR 5 OUT OF 5)** (GOOD OR EXCELLENT)

ALBERTA

SOUTH ZONE

CALGARY ZONE

CENTRAL ZONE

EDMONTON ZONE

NORTH ZONE

64

67

64

62

66

56

51

56

51

48

53

43

77

79

78

75

79

71

* 4 or 5 out of 5 on a 5-point scale where 1 is very dissatisfied and 5 is very satisfied. ** 4 or 5 out of 5 on a 5-point scale were 1 is very difficult and 5 is very easy.


12/12

LISTENING TO ALBERTANSwww.hqca.ca

SATISFACTION AND EXPERIENCE WITH HEALTHCARE SERVICES A SURVEY OF ALBERTANS 2012

12

HOW WE DID THE SURVEY

The Population Research Laboratory at the University

of Alberta conducted the 2012 survey by polling 4,803

Albertans across the five AHS zones. Adults 18 years

of age and older were contacted by phone between

February 24, 2012 and May 27, 2012. The 2012 response

rate was 29.3% and the margin of error was comparable

to previous years at approximately +/- 1.4%, 19 timesout of 20.

The Health Quality Council of Alberta gathers and analyzes

information and collaborates with Alberta Health, Alberta Health

Services, health professions, academia and other stakeholders to

translate that knowledge into practical improvements to health

service quality and patient safety in the healthcare system.

To see the complete results, technical analysis and all

the survey questions, download our Technical Report

at www.hqca.ca.

RESULTS BY ALBERTA HEALTH SERVICES ZONES continued

2012 Summary of other ratings across Alberta Health Services zones

COORDINATION OF CARE SERIOUS COMPLAINT UNEXPECTED HARM HEALTH LINK(% EXCELLENT/VERY GOOD) (% YES) (% EXPERIENCED) (% AWARE)

ALBERTA

SOUTH ZONE

CALGARY ZONE

CENTRAL ZONE

EDMONTON ZONE

NORTH ZONE

Note: Differences may not be statistically significant. See Technical Report for details.

49

49

50

46

50

45

13

15

12

14

13

15

11

11

11

11

11

10

79

76

81

76

80

76

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