Factors Associated With Americans' Ratings of Health Care Quality: What Do They Tell Us About the Raters and the Health Care System?
Factors Associated With Americans' Ratings of Health Care Quality: What Do They Tell Us About the Raters and the Health Care System?
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DOI：
10.1080/10810730.2010.522692
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发表时间：
2010-01-01
影响因子：
4.4
通讯作者：
Hesse, Bradford W.
中科院分区：
文献类型：
--
作者：
Chou, Wen-Ying Sylvia;Wang, Lin Chun;Hesse, Bradford W.
消费者对医疗保健质量的满意度评级代表了医疗保健绩效的常用衡量标准。识别与评级相关的因素将有助于我们了解个人的社会人口统计和健康特征对满意度水平的相对影响，从而为政策制定和临床实践提供信息。现有研究对消费者评级的关键预测因素得出了不同的结果。本研究利用具有全国代表性的数据，旨在确定与美国人的医疗保健质量评级相关的因素。使用加权多项逻辑回归分析 2008 年健康信息全国趋势调查 (HINTS) 的数据来估计消费者评级。预测变量包括人口统计、健康状况、护理获取以及对健康的态度和看法。总体评级呈正偏态； 70% 的受访者将护理评价为“非常好”或“非常好”。 o 少数族裔、心理困扰、未患癌症、没有定期的医疗保健提供者、没有健康保险、对自我护理缺乏信心以及回避医生与较低的评分显着相关。该研究确定了与较低消费者评级相关的心理社会特征。结果强调了使用多种方法评估护理质量的重要性，包括考虑患者特征，并为医疗改革之初评估整体护理质量提供证据基础。
Consumer satisfaction ratings of health care quality represent a commonly used measure of health care performance. Identifying factors associated with ratings will help us understand the relative influence of individuals' sociodemographic and health characteristics on satisfaction level, thus informing policy making and clinical practice. Existing research has yielded mixed results on key predictors of consumer ratings. Using nationally representative data, this study aims to identify factors associated with Americans' ratings of health care quality. Data from 2008 Health Information National Trends Survey (HINTS) were analyzed using weighted multinomial logistic regressions to estimate consumer ratings. Predictor variables included demographics, health status, care access, and attitude and perceptions about health. Overall ratings were positively skewed; 70% of respondents rated care as oexcellento or overy good.o Minority race, psychological distress, not having had cancer, not having a regular health care provider, not having health insurance, lacking confidence in self-care, and avoidance of doctors were significantly associated with lower ratings. The study identifies the psychosocial characteristics associated with lower consumer ratings. The results highlight the importance of using multiple approaches to assess quality of care, including considering patient characteristics, and contribute to the evidence base for evaluating overall quality of care at the dawn of health care reform.