Patient Satisfaction and Its Relationship With Quality and Outcomes of Care After Acute Myocardial Infarction
Patient Satisfaction and Its Relationship With Quality and Outcomes of Care After Acute Myocardial Infarction
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DOI：
10.1161/circulationaha.108.792713
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发表时间：
2008-11-04
期刊：
影响因子：
37.8
通讯作者：
Alter, David A.
中科院分区：
文献类型：
--
作者：
Lee, Douglas S.;Tu, Jack V.;Alter, David A.
背景-患者满意度是一种广泛用于医疗服务评价的测量方法。我们研究了急性心肌梗死后接受的护理质量在多大程度上预测了患者对护理的满意度，以及患者满意度本身是否与急性心肌梗死后的长期生存有关。方法和结果：在急性心肌梗死的纵向队列中，我们检查了患者报告的护理满意度与临床特征、生理和心理功能测量、心肌梗死护理质量指标和结果的关系。在1933例符合条件的患者中（平均年龄62.9±12.8岁，70.5%为男性），分析了1866名调查对象。在研究队列中，1711人（91.7%）报告他们对整体护理感到满意。报告对护理满意的患者年龄较大（平均年龄63.1+/-12.7岁对60.1+/-13.3岁，P=0.005），身体功能改善，抑郁的可能性较小。通过特定活动量表（Specific Activity Scale）测量的更好的身体机能预示着更高的满意度，在调整了年龄、性别、收入水平和种族后，中等功能与较差的OR为1.75 (95% CI 1.17至2.68，P=0.008)，高功能与较差的OR为2.96 （95% CI 1.39至7.34，P=0.009）。抑郁是对整体护理不满意的主要预测因子，OR为0.44 (95% CI 0.29 ~ 0.67， P
Background - Patient satisfaction is a widely used measurement for the evaluation of medical care. We examined the extent to which quality of care received after acute myocardial infarction predicted subsequent patient satisfaction with care and whether patient satisfaction itself was associated with long-term survival after acute myocardial infarction.Methods and Results - In a longitudinal cohort of acute myocardial infarction, we examined the associations of patient-reported satisfaction with care with clinical characteristics, physical and psychological function measures, quality indicators of myocardial infarction care, and outcomes. Among 1933 eligible patients (mean age 62.9+/-12.8 years, 70.5% men), 1866 survey respondents were analyzed. Of the study cohort, 1711 (91.7%) reported that they were satisfied with their overall care. Patients who reported satisfaction with care were older (mean age 63.1+/-12.7 versus 60.1+/-13.3 years, P=0.005), had improved physical function, and were less likely to be depressed. Better physical function, measured by the Specific Activity Scale, predicted higher satisfaction, with an OR of 1.75 (95% CI 1.17 to 2.68, P=0.008) for intermediate versus poor function and 2.96 (1.39 to 7.34, P=0.009) for high versus poor function, after adjustment for age, sex, income tertile, and ethnicity. Depression was the major predictor of dissatisfaction with overall care, with an OR of 0.44 (95% CI 0.29 to 0.67, P