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Patient complaints “tip of the iceberg”, study reveals

Tiny proportion of patients with bad experiences make official complaints

Louise Prime

Friday, 27 January 2012

Only one in five people who feel they have grounds for a complaint about their health care actually do so, Swedish research has shown. Authors of the study, published today in BMJ Open, say healthcare providers should offer more information and support to people who want to make complaints, because their feedback is important in developing and improving healthcare services.

The researchers asked a random sample of 1500 men and women in Stockholm to answer questions about their positive and negative experiences of healthcare. They were also asked whether or not they had ever had legitimate cause to complain about a staff encounter (for themselves or a family member) and, if so, whether or not they had actually filed a complaint.

Among the 992 respondents, almost twice as many said they had generally had positive experiences of healthcare than bad. Reporting having had generally good experience of healthcare was strongly associated with having ‘high trust’ in healthcare, and generally negative experiences with having ‘little trust’.

Of the people who said they had had generally good experiences, 8% still felt they had grounds for complaint but had not done so; this figure was considerably higher for those who reported generally poor experiences (37%).

The authors calculated that overall, nearly a fifth of people (18.5%) who felt they had legitimate grounds to complain had not gone through with making a complaint. The most common reasons given were: ‘I did not have the strength’, ‘I did not know where to turn’ and ‘It makes no difference anyway’; many also said that it was too difficult.

The researchers argue that patients’ trust in healthcare is essential to their health and even safety, and warn: “Some respondents chose not to complain due to fear of reprimands, such as receiving worse care or having their treatment withdrawn – an alarming result that also implies a considerable lack of trust among some of the respondents.”

They conclude: “[Our] study indicates that healthcare complaints filed … reveal only the tip of an iceberg. Complaints seem to be considerably under reported, especially among those with a negative general experience of healthcare.

“In order to develop and improve the quality of healthcare encounters and services, by assuring critical feedback, it is important that healthcare providers offer more information and support to patients who want to make complaints.”

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