Carrasquillo O, Orav E J, Brennan T A, Burstin H R
Department of Medicine, Cambridge Hospital, Mass, USA.
J Gen Intern Med. 1999 Feb;14(2):82-7. doi: 10.1046/j.1525-1497.1999.00293.x.
To examine patient satisfaction and willingness to return to an emergency department (ED) among non-English speakers.
Cross-sectional survey and follow-up interviews 10 days after ED visit.
Five urban teaching hospital EDs in the Northeastern United States.
We surveyed 2,333 patients who presented to the ED with one of six chief complaints.
Patient satisfaction, willingness to return to the same ED if emergency care was needed, and patient-reported problems with care were measured. Three hundred fifty-four (15%) of the patients reported English was not their primary language. Using an overall measure of patient satisfaction, only 52% of non-English-speaking patients were satisfied as compared with 71% of English speakers (p < .01). Among non-English speakers, 14% said they would not return to the same ED if they had another problem requiring emergency care as compared with 9.5% of English speakers (p < .05). In multivariate analysis adjusting for hospital site, age, gender, race/ethnicity, education, income, chief complaint, urgency, insurance status, Medicaid status, ED as the patient's principal source of care, and presence of a regular provider of care, non-English speakers were significantly less likely to be satisfied (odds ratio [OR] 0.59; 95% confidence interval [CI] 0.39, 0.90) and significantly less willing to return to the same ED (OR 0.57; 95% CI 0.34, 0.95). Non-English speakers also were significantly more likely to report overall problems with care (OR 1.70; 95% CI 1.05, 2.74), communication (OR 1.71; 95% CI 1.18, 2.47), and testing (OR 1.77; 95% CI 1.19, 2.64).
Non-English speakers were less satisfied with their care in the ED, less willing to return to the same ED if they had a problem they felt required emergency care, and reported more problems with emergency care. Strategies to improve satisfaction among this group of patients may include appropriate use of professional interpreters and increasing the language concordance between patients and providers.
调查非英语患者的满意度以及返回急诊科就诊的意愿。
横断面调查及急诊就诊10天后的随访访谈。
美国东北部五家城市教学医院的急诊科。
我们对2333例因六种主要主诉之一前来急诊科就诊的患者进行了调查。
测量了患者满意度、若需要急诊护理时返回同一家急诊科的意愿以及患者报告的护理问题。354例（15%）患者报告英语并非其主要语言。采用患者满意度综合指标，仅52%的非英语患者表示满意，而英语患者的这一比例为71%（p <.01）。在非英语患者中，14%表示若遇到另一个需要急诊护理的问题，他们不会返回同一家急诊科，而英语患者的这一比例为9.5%（p <.05）。在对医院地点、年龄、性别、种族/民族、教育程度、收入、主要主诉、紧急程度、保险状况、医疗补助状况、该急诊科是否为患者主要护理来源以及是否有固定护理提供者进行多变量分析时，非英语患者满意度显著较低（比值比[OR] 0.59；95%置信区间[CI] 0.39，0.90），且返回同一家急诊科的意愿也显著较低（OR 0.57；95% CI 0.34，0.95）。非英语患者报告护理总体问题（OR 1.70；95% CI 1.05，2.74）、沟通问题（OR 1.71；95% CI 1.18，2.47）和检查问题（OR 1.77；95% CI 1.19，2.64）的可能性也显著更高。
非英语患者对其在急诊科接受的护理满意度较低，若遇到他们认为需要急诊护理的问题，返回同一家急诊科的意愿较低，且报告的急诊护理问题更多。提高这类患者满意度的策略可能包括合理使用专业口译人员以及增加患者与医护人员之间的语言匹配度。
