How does satisfaction with the health-care system relate to patient experience?
How does satisfaction with the health-care system relate to patient experience?
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DOI：
10.2471/blt.07.050401
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发表时间：
2009-04-01
期刊：
影响因子：
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通讯作者：
Murray, Christopher JL
中科院分区：
文献类型：
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作者：
Bleich, Sara N;Özaltin, Emre;Murray, Christopher JL
目的探讨是什么决定了人们对卫生保健系统的满意度高于他们作为病人的经验。方法卫生系统反应性的数据，这是指人们在寻求卫生保健时所接受的方式和环境，提供了一个独特的机会，更好地了解人们对健康满意度的决定因素-护理系统以及个人作为患者的经历对这一点的影响有多大。这些数据来自2003年世界卫生调查中的21个欧洲联盟国家。添加剂普通最小二乘回归模型被用来评估在何种程度上通常与卫生保健系统的满意度相关的变量，在文献中记录，解释周围的满意度的概念的变化。使用残差分析来确定对医疗保健系统满意度的其他预测因素。结果患者体验与对医疗保健系统的满意度显着相关，并解释了满意度概念周围10.4%的变化。其他因素，如病人的期望，健康状况，护理类型和免疫覆盖率也是卫生系统满意度的重要预测因素;尽管它们加在一起只解释了观察到的变异的17.5%，而更广泛的社会因素可能在很大程度上解释了对卫生保健系统满意度的无法解释的部分。人们对保健系统的满意程度更多地取决于保健系统外部的因素，而不是作为病人的保健经验。因此，衡量后者作为质量改进和卫生系统改革的基础可能用处有限。
Objective To explore what determines people's satisfaction with the health-care system above and beyond their experience as patients.Methods Data on health system responsiveness, which refers to the manner and environment in which people are treated when they seek health care, provides a unique opportunity to better understand the determinants of people's satisfaction with the health-care system and how strongly this is influenced by an individual's experience as a patient. The data were obtained from 21 European Union countries in the World Health Survey for 2003. Additive ordinary least-squares regression models were used to assess the extent to which variables commonly associated with satisfaction with the health-care system, as recorded in the literature, explain the variation around the concept of satisfaction. A residual analysis was used to identify other predictors of satisfaction with the health-care system.Findings Patient experience was significantly associated with satisfaction with the health-care system and explained 10.4% of the variation around the concept of satisfaction. Other factors such as patient expectations, health status, type of care, and immunization coverage were also significant predictors of health system satisfaction; although together they explained only 17.5% of the observed variation, while broader societal factors may largely account for the unexplained portion of satisfaction with the health-care system.Conclusion Contrary to published reports, people's satisfaction with the health-care system depends more on factors external to the health system than on the experience of care as a patient. Thus, measuring the latter may be of limited use as a basis for quality improvement and health system reform.