Lytle R S, Mokwa M P
Abilene Christian University.
J Health Care Mark. 1992 Mar;12(1):4-14.
An integrative model of health care quality is presented. "Health care quality" is defined as provider conformance to patient requirements at three benefit levels: core, intangible, and tangible. The model is operationalized and tested in a clinical setting, a large center for fertility studies with more than 5000 patients. Health care "process variables" such as physician and patient interactions were not as important in patients' evaluations of health care quality when successful outcomes occurred (pregnancy). However, when patients experienced unsuccessful outcomes (no pregnancy), health care "process variables" were important and had a significant influence on patient perceptions of health care quality. Hence, service outcomes can significantly affect the measurement and interpretation of health care quality. Implications for health care management and research are discussed.
提出了一种医疗保健质量的综合模型。“医疗保健质量”被定义为提供者在三个效益水平上符合患者需求：核心、无形和有形。该模型在一个临床环境中进行了实施和测试，这是一个拥有超过5000名患者的大型生育研究中心。当出现成功结果（怀孕）时，诸如医生与患者互动等医疗保健“过程变量”在患者对医疗保健质量的评估中并不那么重要。然而，当患者经历不成功的结果（未怀孕）时，医疗保健“过程变量”很重要，并且对患者对医疗保健质量的认知有显著影响。因此，服务结果会显著影响医疗保健质量的衡量和解读。讨论了对医疗保健管理和研究的启示。
