Dossier n. 230/2012 [Abstract] Citizens’ remarks to the Offices for relations with the public at Health Trusts. Regional report 2011

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 citizens’ confidence in the Health system.

The volume presents the analysis of all remarks registered from January 1st through December 31st, 2011 and a study on the 2003-2011 trend of all kinds of remarks.

In 2011 21,613 remarks were presented (20,402 by citizens), in particular:

• 8,977 complaints (41,5% of the total),
• 9,150 praises (42,3% of the total),
• 2,611 notes (12,1% of the total),
• 426 suggestions (2% of the total),
• 449 improper remarks (2,1% of the total).

A constant increase of remarks can be noticed, from 12,001 in 2003 to 21,613 in 2011 (+80% in 9 years).

The 2003-2011 trend analysis on the different types of remarks highlights a progressive reduction of the distance between complaints and praises (that in 2003 were half of the complaints), and in 2011 the inversion of the two trends is reached: for the first time since 2003 praises are more than complaints at regional level.

As in previous years, also in 2011 “technical professional aspects” collect most remarks (35% of the total); this demonstrates that citizens give importance to the quality of provision both in negative and in positive terms: the category collected 1,792 complaints (corresponding to 20% of total complaints) and 5,608 praises (61% of total praises). The 2010-2011 trend analysis show a very slight increase of complaints (+1%) and a strong increase of praises (+34%) for these aspects.

“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. In 2011 1,870 complaints (21% of total complaints) and 865 notes (33% of total notes) were presented.

The category “time” shows a relevant increase of complaints from 2003 to 2011 (+42%). Also the “economic aspects” register many complaints (1,591, 18% of total complaints), in particular in the subcategory “challenge to the ticket as requested reimbursement of health services” (62% 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. In particular, some aspects can be studied:

• general trend of remarks for each type;
• analysis of remark content;
• trend analysis per type, Health Trust and care function;
• analysis of remarks that can be useful for risk management;
• environments where remarks arise;
• remark analysis per outcome.

The present Dossier is the last of a report series started in 2005 with the first volume (Dossier n. 114/2005). From next year, the database collecting citizens’ remarks presented at the Offices for relations with the public at Health Trusts will be supported also by other information sources - first of all the regional database of perceived quality in hospital wards -, thus creating a new integrated report system that - using different tools to read citizens’ opinions and attitudes toward health services - allows a more structured analysis of the regional reality.