Integrating Patient-reported Experience (PRE) in a multistage approach to study access to health services for women with chronic illness and migration experience.

Abel, Thomas; Tadesse, Lidya; Frahsa, Annika; Sakarya, Sibel (2023). Integrating Patient-reported Experience (PRE) in a multistage approach to study access to health services for women with chronic illness and migration experience. Health expectations, 26(1), pp. 237-244. Blackwell Publishing 10.1111/hex.13649

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BACKGROUND

Patient-reported Experience (PRE) is an emerging concept integrating patient perspectives and amplifying voices often marginalized in discussions surrounding health systems. However, it remains a challenge to use and integrate PREs when studying patient agency and access to quality services, particularly with data from multiple sources. In this article, using study materials from the Swiss MIWOCA project, we present and reflect upon a multistage PRE approach to study healthcare access.

METHODS

The MIWOCA project, a study on healthcare access and quality among immigrant women with chronic illnesses living in Switzerland, provided data from multiple sources for the integration of PRE data. These sources included interviews with women (n = 48), two focus group discussions with women (n = 15), interviews with service providers (n = 12) and observations from stakeholder dialogues (n = 3). In addition, we utilized field notes, focus group illustration maps, patient vignettes and policy briefs to develop a multistage data linking model. PRE data served as starting themes and reference topics in each of the interlinked stages of knowledge production.

RESULTS

Deploying PREs, we coherently linked the data from preceding stages and used them to inform subsequent stages. This, in turn, enabled us to identify, reflect and rectify factors limiting immigrant women's agency and access to quality services. Ultimately, the approach engaged patients as knowledge co-producers for system-level changes. This knowledge was transformed into a set of practice recommendations and a policy brief addressing ways to improve health systems to better serve immigrant women in Switzerland.

CONCLUSIONS

Building on PREs to systematically combine multiple data sources and engage patients continuously can improve our understanding of barriers in health systems. Beyond individual patient-doctor encounters, a multistage PRE approach can identify structural problems and provide clues for resolving them at the systems level. The PREs approach presented may serve as an example and encourage more public health experts to consider PREs in future research and practice.

PATIENT AND PUBLIC CONTRIBUTION

Women with chronic illness and immigration experience contributed to interview-guideline development, provided PREs in interviews, identified priority areas for health-service change and actively participated in the development of practice recommendations.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > Institute of Social and Preventive Medicine (ISPM)

UniBE Contributor:

Abel, Thomas, Tadesse, Lidya Dawit, Frahsa, Annika

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

1369-6513

Publisher:

Blackwell Publishing

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Pubmed Import

Date Deposited:

24 Nov 2022 09:16

Last Modified:

01 Feb 2023 12:10

Publisher DOI:

10.1111/hex.13649

PubMed ID:

36416363

Uncontrolled Keywords:

agency health services immigrant women inequity methodology patient experience

BORIS DOI:

10.48350/175112

URI:

https://boris.unibe.ch/id/eprint/175112

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