A comparison of the quality of care in accident and emergency departments in England and the Netherlands as experienced by patients

摘要

Background Measuring patients’ experiences to determine health‐care performance and quality of care from their perspective can provide valuable evidence for international improvements in the quality of care. We compare patients’ experiences in Accident & Emergency departments (A&E) in England and the Netherlands and discuss the usefulness of this comparison. Methods A cross‐sectional survey was conducted among patients attending A&Es aged 18?years and older. In England, 134 A&Es were surveyed. In the Netherlands, nine hospitals participated in the study. Main outcome measures were patients’ experiences represented by six domain scores aggregated on the country level or on the A&E level. Results In England, 43?892 completed questionnaires were received (40%). In the Netherlands, 1865 completed questionnaires were received (42%). Three of six domain scores were significantly higher for patients in the Netherlands: ‘waiting time’ [mean scores of 73.8 ( NL ) versus 67.2 ( ENG )], ‘doctors and nurses’ [mean scores of 85.7 ( NL ) versus 80.6 ( ENG )] and ‘your care and treatment’ [mean scores of 82.6 ( NL ) and 80.2 ( ENG )]. The variance among the English A&Es was large. The best and worst practices on five domains were English. Conclusions The mean quality of care in the A&E appeared to be better in the Netherlands on three domains, but the best practices were English A&Es. The within‐country differences between A&Es were much larger than differences between countries. Healthcare performance in the A&E can be compared between countries by surveying patients’ experiences, and there seems much to learn across A&Es both within and among countries.