The Association between Clinical Outcomes and Experienced Quality of Outpatient Care among Patients Treated for Atrial Fibrillation

Document Type : Original Article


1 Netherlands Heart Network, Veldhoven, the Netherlands.

2 Catharina Hospital, Eindhoven, the Netherlands.

3 Máxima Medical Center, Veldhoven, the Netherlands.

4 St. Anna Hospital, Geldrop, the Netherlands.

5 Elkerliek Hospital, Helmond, the Netherlands.

6 GP Organization ELAN, Helmond, the Netherlands.

7 GP Organization PoZoB, Veldhoven, the Netherlands.

8 Diagnostics for You, Eindhoven, the Netherlands.

9 Department of Electrical Engineering, Technical University, Eindhoven, the Netherlands.


Introduction: Patient-Reported Experience Measures (PREMs) are commonly used to indicate patients’ experiences in atrial fibrillation (AF) care. As outcomes are the primary goal in Value-Based Health Care, questions are raised regarding whether those experiences represent AF patients’ relevant outcomes. Therefore, this study aims to assess whether a questionnaire concerning AF patients’ experienced quality of care is correlated with AF patients’ clinical outcomes.
Materials and Methods: Data of the present study originated from a prospective cohort study performed among outpatient AF patients in the Netherlands. In October 2015, all patients were asked to complete the Consumer Quality Index (CQI) to assess their experiences with the outpatient AF clinic. Analyses are performed to assess the association between patients’ experiences and clinical outcomes of AF patients (i.e. EHRA score) after three and six months of follow-up.
Results: A total of 242 AF patients (68.7 years) met the inclusion criteria. Regarding the eight domains of the CQI, only provided information (B=3.10; p=0.01) and the physicians’ communication (B=-3.13; p=0.03) were associated with improved EHRA scores at three months. After six months, EHRA score improvements were associated with only one out of eight CQI indicators, namely the information AF patients received from other healthcare providers (B=-5.15; p<0.01).
Conclusion: An inconsistent correlation between AF patients’ clinical outcomes and AF patients’ PREMs was found. Although PREMs are relevant in healthcare, they cannot replace outcomes as a measure of medical care quality. For healthcare organizations, it is crucial to identify the required strategy for assessing the various aspects of the quality of services provided.


Main Subjects

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