Patient-reported outcomes of adults with congenital heart disease from eight European countries: scrutinising the association with healthcare system performance.

Journal: European journal of cardiovascular nursing

Volume: 18

Issue: 6

Year of Publication: 2020

Affiliated Institutions:  Department of Public Health and Primary Care, KU Leuven - University of Leuven, Belgium. School Psychology and Development in Context, KU Leuven - University of Leuven, Belgium. Peter Munk Cardiac Centre, University of Toronto, Canada. Center for Congenital Heart Disease, Bern University Hospital, Switzerland. Division of Congenital and Structural Cardiology, University Hospitals Leuven, Belgium. Department of Cardiology, Academic Medical Center, The Netherlands. Department of Cardiology, Oslo University Hospital - Rikshospitalet, Norway. Centre for Person-Centred Care (GPCC), University of Gothenburg, Sweden. Department of Public Health and Clinical Medicine, Umeå University, Sweden. Department of Cardiology, Mater Dei Hospital, Malta. Department of Congenital Heart Disease, Louis Pradel Hospital, France. Clinical Psychology Service, IRCCS Policlinico San Donato, Italy.

Abstract summary 

Inter-country variation in patient-reported outcomes of adults with congenital heart disease has been observed. Country-specific characteristics may play a role. A previous study found an association between healthcare system performance and patient-reported outcomes. However, it remains unknown which specific components of the countries' healthcare system performance are of importance for patient-reported outcomes.The aim of this study was to investigate the relationship between components of healthcare system performance and patient-reported outcomes in a large sample of adults with congenital heart disease.A total of 1591 adults with congenital heart disease (median age 34 years; 51% men; 32% simple, 48% moderate and 20% complex defects) from eight European countries were included in this cross-sectional study. The following patient-reported outcomes were measured: perceived physical and mental health, psychological distress, health behaviours and quality of life. The Euro Health Consumer Index 2015 and the Euro Heart Index 2016 were used as measures of healthcare system performance. General linear mixed models were conducted, adjusting for patient-specific variables and unmeasured country differences.Health risk behaviours were associated with the Euro Health Consumer Index subdomains about patient rights and information, health outcomes and financing and access to pharmaceuticals. Perceived physical health was associated with the Euro Health Consumer Index subdomain about prevention of chronic diseases. Subscales of the Euro Heart Index were not associated with patient-reported outcomes.Several features of healthcare system performance are associated with perceived physical health and health risk behaviour in adults with congenital heart disease. Before recommendations for policy-makers and clinicians can be conducted, future research ought to investigate the impact of the healthcare system performance on outcomes further.

Authors & Co-authors:  Van Bulck Liesbet L Luyckx Koen K Goossens Eva E Apers Silke S Kovacs Adrienne H AH Thomet Corina C Budts Werner W Sluman Maayke A MA Eriksen Katrine K Dellborg Mikael M Berghammer Malin M Johansson Bengt B Caruana Maryanne M Soufi Alexandra A Callus Edward E Moons Philip P

Study Outcome 

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Statistics
Citations : 
Authors :  16
Identifiers
Doi : 10.1177/1474515119834484
SSN : 1873-1953
Study Population
Male,Female
Mesh Terms
Adult
Other Terms
Healthcare system performance;congenital;health services accessibility;heart defect;patient reported outcome measures
Study Design
Cross Sectional Study
Study Approach
Mixed Methods
Country of Study
Publication Country
England