Creating a Patient-Centered Health Care Delivery System: A Systematic Review of Health Care Quality From the Patient Perspective

Am J Med Qual. 2016 Jan-Feb;31(1):12-21. doi: 10.1177/1062860614545124. Epub 2014 Jul 31.


Patient experience is one of key domains of value-based purchasing that can serve as a measure of quality and be used to improve the delivery of health services. The aims of this study are to explore patient perceptions of quality of health care and to understand how perceptions may differ by settings and condition. A systematic review of multiple databases was conducted for studies targeting patient perceptions of quality of care. Two reviewers screened and extracted data independently. Data synthesis was performed following a meta-narrative approach. A total of 36 studies were included that identified 10 quality dimensions perceived by patients: communication, access, shared decision making, provider knowledge and skills, physical environment, patient education, electronic medical record, pain control, discharge process, and preventive services. These dimensions can be used in planning and evaluating health care delivery. Future research should evaluate the effect of interventions targeting patient experience on patient outcomes.

Keywords: health care delivery; meta-narrative review; patient perceptions; quality of health care; systematic review.

Publication types

  • Review
  • Systematic Review

MeSH terms

  • Communication
  • Decision Making
  • Electronic Health Records / organization & administration
  • Environment
  • Health Knowledge, Attitudes, Practice
  • Health Services Accessibility / organization & administration
  • Humans
  • Pain Management
  • Patient Education as Topic / organization & administration
  • Patient Participation
  • Patient Satisfaction*
  • Perception*
  • Preventive Health Services / organization & administration
  • Quality of Health Care / organization & administration*