Dossier n. 220/2012 [Abstract] Citizens’ remarks to the Offices for relations with the public at Health Trusts. Regional report 2010

Since 2003 an informatics system was implemented in all the Health Trusts of Emilia-Romagna to collect and manage citizens’ remarks (complaints, praises, notes, suggestions); this system allows health organizations to have a feedback on their activities and to get data and information in order to improve care paths, to recognize their strengths and to increase citizen’s confidence in the Health system.

The volume presents the analysis of all remarks registered from January 1st through December 31st, 2010 and a study on the 2003-2010 trend of all kinds of remarks.

In 2010 20,704 remarks were presented (19,060 by citizens), in particular:

• 8,546 complaints (41.3% of the total),
• 8,382 praises (40.5% of the total),
• 2,768 notes (13.4% of the total),
• 522 suggestions (2.5% of the total),
• 486 improper remarks (2.3% of the total).

A general increase of remarks can be noticed, from 12,001 in 2003 to 20,704 in 2010 (+8,703). The 2003-2010 trend analysis on the different types of remarks highlights a decrease of complaints in comparison to praises: the analysis of the absolute values in 2009 and 2010 shows a lower increase in complaints (from 8,306 to 8,546) compared with praises (from 6,750 to 8,382), while the analysis of percentages highlights a decrease of complaints (-2.9%) and an increase of praises (+4.5%).

As in previous years, also in 2010 “technical professional aspects” collect most remarks; this demonstrates that citizens give importance to the quality of provision both in negative and in positive terms: the category collected 1,775 complaints (corresponding to 21% of total complaints) and 4,198 praises (50% of total praises).

“Relational aspects” collected most praises - in particular for “courtesy and kindness” - confirming the positive trend of the preceding years.

Many remarks concern “Organization bureaucratic administrative aspects”, as in the past; however in 2010, citizens’ dissatisfaction has partly changed: the increase of suggestions (200 corresponding to 38% of total suggestions) shows citizens active contributions to improve service quality.

The category “time” in 2010 shows a decrease of complaints, compared with the preceding years: from 1.434 in 2009 to 1.176 in 2010.

Between 2009 and 2010 an increase of complaints is registered in “economic aspects” (from 895 to 1.556) - in particular “objection to the ticket as reimbursement of health services” (66,1% of complaints in the “economic aspect”).

The analysis of remarks distribution in the Health Trusts of Emilia-Romagna offers interesting indications as it represents an indicator of how each Health Trust uses the informatics system and also of how the population of that area believes that their opinion will be listened by the health organization. The 2010 analysis also presents the description of some Health Trusts’ experiences, to underline the potential of the system with respect to data analysis and organizational management.

Finally, some attention is focused on management elements that influence the system; in the 2007-2008 period, the Regional Agency for Health and Social Care and the Offices for Relations with the Public of the Health Trusts have elaborated some operational instruments to facilitate data entry and interpretation. The outputs will also partially contribute in overcoming possible differences in the use of the system by the various Health Trusts; however, by now the system is not yet fully implemented, and some applications - in particular those that allow to register remarks concerning risk management - are not fully used.