Measuring patient satisfaction for quality improvement
Measuring patient satisfaction for quality improvement
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DOI：
10.1097/00005650-199912000-00004
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发表时间：
1999-12-01
期刊：
影响因子：
3
通讯作者：
Tierney, WM
中科院分区：
文献类型：
--
作者：
Harris, LE;Swindle, RW;Tierney, WM
背景资料。用于健康计划质量报告的调查通常每年向健康计划加入者进行，以评估对健康计划和医疗保健服务的满意度。因此，调查可能缺乏敏感性来衡量以患者为中心的质量改进倡议的效果，这些倡议可能会在较短的时间内展示结果。目的：我们描述了一种可用于质量改进的多维、特定于访客的初级保健满意度测量方法。方法：在五个服务于商业、主要由管理人员管理的人群的成人和儿科初级保健站点进行的调查，包括医疗结果研究访问特定问卷、美国内科委员会患者满意度问卷和当地开发的项目。我们评估了该工具的可靠性、有效性和对质量改进的实用性。结果：对于成人和儿童样本，出现了三个因素：对提供者的满意度，对访问的满意度，以及对办公室的满意度。在两个样本中，对提供者和办公室的满意度与总体满意度独立相关；对接入的满意度与总体满意度只有成年人显著相关。对于成年人来说，与继续参加健康计划的患者相比，退出健康计划的患者对办公室的满意度较低。最后，对于成人，我们发现不同实习地点对办公室和通道的满意度存在显著差异；对于儿童，对提供者、办公室和通道的满意度存在站点间差异。结论：我们支持该工具的可靠性和有效性，该工具确定了可用于质量改进的不同实践站点之间的满意度差异。
BACKGROUND. Surveys used for health plan quality reporting are generally administered annually to health plan enrollees to assess satisfaction with both the health plan and health care services. Therefore, surveys may lack sensitivity to measure the effects of patient-focused, quality improvement initiatives that could demonstrate results in a shorter time period.OBJECTIVES. We describe the development and testing of a multidimensional, visit-specific measure of satisfaction with primary care that may be used in quality improvement.METHODS. Conducted in five adult and pediatric primary care sites serving a commercial, largely managed-care population, the survey includes the Medical Outcomes Study Visit-Specific Questionnaire, the American Board of Internal Medicine Patient Satisfaction Questionnaire, and locally developed items. We assessed the instrument's reliability, validity, and utility for quality improvement.RESULTS. For both adult and pediatric samples, three factors emerged: satisfaction with the provider, satisfaction with access, and satisfaction with the office. Satisfaction with the provider and with the office were independently correlated with overall satisfaction in both samples; satisfaction with access was significantly correlated with overall satisfaction only for adults. For adults, patients who disenrolled from the health plan were less satisfied with the office compared with patients who remained with the health plan. Finally, for adults, we detected significant differences across practice sites in terms of satisfaction with office and access; for children, there were intersite differences in terms of satisfaction with provider, office, and access.CONCLUSIONS. We have support for the reliability and validity of this instrument that has identified differences in satisfaction between practice sites that may be used for quality improvement.