A nationwide participatory programme to measure person-centred hospital care in Italy: Results and implications for continuous improvement

Background: Patient-centredness has been targeted by the Italian government as akey theme for the future development of health services.Objective: Measuring patient-centredhealth services in partnership with citizens,health professionals and decision makers.Design: National participatory survey in a large test set of hospitals at national level.Setting and participants: A total of 387 hospital visits conducted in 16 Italian regionsby over 1,500 citizens and health professionals during 2017-2018.Main variables and outcome measures: An ad hoc checklist was used to assessperson-centrednessin hospital care through 243 items, grouped in 4 main areas,12 sub-areasand 29 person-centredcriteria (scored 0-10).GEE linear multivariateregression was used to explore the relation between hospital characteristics andperson-centredness.Results: Person-centredscores were moderately high, with substantial variationoverall (median score: 7.0, range: 3.2-9.5)and by area (Care Processes: 6.8, 2.0-9.8;Access: 7.4, 2.7-9.7;Transparency: 6.7, 3.4-9.5and Relationship: 7.3, 0.8-10.0).Multivariate regression found higher scores for increasing volumes of activity (quartileincrease: +0.21; 95% CI: 0.13, 0.29) and lower scores in the south and islands(−1.03; −1.62,-0.45).Discussion: The checklist has been applied successfully by over 1,500 collaboratorswho assessed hospitals in 16 distinct Regions and Autonomous Provinces of Italy.Despite an overall positive mark, all scores were highly variable by location and hospitalcharacteristics.Conclusion and patient or public contribution: A national participatory programmeto improve patient-centrednessin Italian hospitals highlighted critical areas with thedirect input of citizens.