QUALITY OF CARE FOR INFERTILITY PATIENTS - AN EVALUATION OF A PLAN FOR A HOSPITAL INVESTIGATION

Aim of study. In this study we assessed the quality of health care for infertile patients as expressed by the patients themselves. The imple mentation of the existing structured plan for infertility investigatio n and treatment was also reviewed. Design and data. The sample consist ed of all 361 women registered with an infertility diagnosis during 19 82 at Riks-hospitalet. Their medical records were reviewed in 1988. Th e process and outcome of the investigation as it appeared was analyzed for each individual patient. A structured questionnaire was distribut ed to the patients in 1988 and 72.6% responded. The questions included several items on outcome and personal experience of the treatment in the hospital.Results. Data from the medical records show that the medi cal investigation lasted three years on average. The records often sho wed evidence of discontinuity of the process. The mean number of consu ltations was eight (range 1-28). An average of one new doctor for each consultation was involved in the investigation. One third of the pati ents left the investigation without a noted definite termination of th e treatment process. According to the questionnaire around 40% had del ivered at least one child, while 30% had adopted. Of those who got a b iological child, two thirds were satisfied with the clinical treatment efforts of the medical staff. Less than half of those who did not bec ome pregnant were satisfied. Independent of outcome, 70% were dissatis fied with the emotional support during the investigations, and nearly 90% felt that waiting lists were too long. More than half expressed a need for professional psychological counselling. Conclusions. The stud y shows that medical records and service organizations do not meet the need for continuity in treatment nor research and evaluation requirem ents. We suggest that more emphasis should be devoted to planning of t he services. They should be improved with regard to quality in medical handling as well as emotional counselling.