Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach

Objective: To identify patient and family practice characteristics associated with patient-reported experiences of safety problems and harm. Design: Cross-sectional study combining data from the individual postal administration of the validated Patient Reported Experiences and Outcomes of Safety in...

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Main Authors: Ricci Cabello, Ignacio, Reeves, David, Bell, Brian G., Valderas, Jose M.
Format: Article
Published: BMJ Publishing Group 2017
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Online Access:https://eprints.nottingham.ac.uk/44395/
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author Ricci Cabello, Ignacio
Reeves, David
Bell, Brian G.
Valderas, Jose M.
author_facet Ricci Cabello, Ignacio
Reeves, David
Bell, Brian G.
Valderas, Jose M.
author_sort Ricci Cabello, Ignacio
building Nottingham Research Data Repository
collection Online Access
description Objective: To identify patient and family practice characteristics associated with patient-reported experiences of safety problems and harm. Design: Cross-sectional study combining data from the individual postal administration of the validated Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire to a random sample of patients in family practices (response rate =18.4%) and practice level data for those practices obtained from NHS Digital. We built linear multilevel multivariate regression models to model the association between patient (clinical and sociodemographic) and practice level (size and case-mix, human resources, indicators of quality and safety of care, and practice safety activation) characteristics, and outcome measures. Setting: General practices distributed across five regions in the North, Centre and South of England. Participants: 1,190 patients registered in 45 practices purposefully sampled (maximal variation in practice size and levels of deprivation). Main outcome measures: Self-reported safety problems, harm, and overall perception of safety. Results: Higher self-reported levels of safety problems were associated with younger age of patients (beta coefficient 0.15) and lower levels of practice safety activation (0.44). Higher self-reported levels of harm were associated with younger age (0.13) and worse self-reported health status (0.23). Lower self-reported healthcare safety was associated with lower levels of practice safety activation (0.40). The fully adjusted models explained 4.5% of the variance in experiences of safety problems, 8.6% of the variance in harm, and 4.4% of the variance in perceptions of patient safety. Conclusions: Practices’ safety activation levels and patients’ age and health status are associated with patient-reported safety outcomes in English family practices. The development of interventions aimed at improving patient safety outcomes would benefit from focusing on the identified groups.
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spelling nottingham-443952020-05-04T19:54:54Z https://eprints.nottingham.ac.uk/44395/ Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach Ricci Cabello, Ignacio Reeves, David Bell, Brian G. Valderas, Jose M. Objective: To identify patient and family practice characteristics associated with patient-reported experiences of safety problems and harm. Design: Cross-sectional study combining data from the individual postal administration of the validated Patient Reported Experiences and Outcomes of Safety in Primary Care (PREOS-PC) questionnaire to a random sample of patients in family practices (response rate =18.4%) and practice level data for those practices obtained from NHS Digital. We built linear multilevel multivariate regression models to model the association between patient (clinical and sociodemographic) and practice level (size and case-mix, human resources, indicators of quality and safety of care, and practice safety activation) characteristics, and outcome measures. Setting: General practices distributed across five regions in the North, Centre and South of England. Participants: 1,190 patients registered in 45 practices purposefully sampled (maximal variation in practice size and levels of deprivation). Main outcome measures: Self-reported safety problems, harm, and overall perception of safety. Results: Higher self-reported levels of safety problems were associated with younger age of patients (beta coefficient 0.15) and lower levels of practice safety activation (0.44). Higher self-reported levels of harm were associated with younger age (0.13) and worse self-reported health status (0.23). Lower self-reported healthcare safety was associated with lower levels of practice safety activation (0.40). The fully adjusted models explained 4.5% of the variance in experiences of safety problems, 8.6% of the variance in harm, and 4.4% of the variance in perceptions of patient safety. Conclusions: Practices’ safety activation levels and patients’ age and health status are associated with patient-reported safety outcomes in English family practices. The development of interventions aimed at improving patient safety outcomes would benefit from focusing on the identified groups. BMJ Publishing Group 2017-11 Article PeerReviewed Ricci Cabello, Ignacio, Reeves, David, Bell, Brian G. and Valderas, Jose M. (2017) Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach. BMJ Quality & Safety, 26 (11). pp. 899-907. ISSN 2044-5423 Patient safety; Patient-reported; Primary Care http://qualitysafety.bmj.com/content/26/11/899 doi:10.1136/bmjqs-2016-006411 doi:10.1136/bmjqs-2016-006411
spellingShingle Patient safety; Patient-reported; Primary Care
Ricci Cabello, Ignacio
Reeves, David
Bell, Brian G.
Valderas, Jose M.
Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach
title Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach
title_full Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach
title_fullStr Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach
title_full_unstemmed Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach
title_short Identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach
title_sort identifying patient and practice characteristics associated with patient-reported experiences of safety problems and harm: a cross-sectional study using a multilevel modelling approach
topic Patient safety; Patient-reported; Primary Care
url https://eprints.nottingham.ac.uk/44395/
https://eprints.nottingham.ac.uk/44395/
https://eprints.nottingham.ac.uk/44395/