Nevertheless, our understanding of patient perceptions of quality is still in its childhood, if not its infancy, in part because patients themselves still have fairly inchoate and pliable understandings of what quality means and, as noted in Hibbard & Peters' earlier Annual Review chapter ( 31), tend to have constructed rather than stable preferences about health related choices. These are just two of the many signs that, within health care, the role of patients has gained greater significance for many, though not all, providers, policy makers, and researchers. Further, among its simple rules to achieve quality are two rules stating that “ustomization based on patients' needs and values” is needed and that “he patient is the source of control” of interactions with the health care delivery system 1 ( 35). In its groundbreaking work Crossing the Quality Chasm, the Institute of Medicine identified providing patient-centered care as one of six aims of the health care system ( 35). INTRODUCTION Purpose and Content of this Chapter Our aim is to find out what patients want, need and experience in health care, not what professionals (however well-motivated) believe they need or get. We propose a conceptual model to help unravel these knotty issues review qualitative studies that report directly from patients on how they define quality provide an overview of how health plans, hospitals, physicians, and health care in general are currently viewed by patients assess whether and how patient health status and demographic characteristics relate to perceptions of health care quality and identify where further, or more appropriately designed, research is needed. This chapter identifies conceptual and methodological issues that make this task difficult, including the confusion between patient perceptions and patient satisfaction and the difficulty of determining whether systematic variations in patient perceptions should be attributed to differences in expectations or actual experiences.
▪ Abstract As calls are made for a more patient-centered health care system, it becomes critical to define and measure patient perceptions of health care quality and to understand more fully what drives those perceptions.
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