Finkelstein B S, Harper D L, Rosenthal G E
Department of Epidemiology and Biostatistics, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
Am J Manag Care. 1998 Dec;4(12):1701-8.
To examine the relationship between patients' satisfaction with hospital obstetric care, length of stay, and patients' perceived appropriateness of the length of stay.
A cross-sectional study.
We surveyed 27,789 women (a 58% response rate) discharged after labor and delivery from 18 hospitals in a large metropolitan region from 1992 through 1994. Patient satisfaction was assessed using the Patient Judgment System, a previously validated instrument. Our analysis focused on four scales evaluating specific aspects of care (physician care, nursing care, provision of information, and preparation for discharge) and two single-item indicators of satisfaction (overall quality and willingness to return to the hospital).
Patients with shorter lengths of stay were more likely (P < 0.001) to perceive their stays as "too short." In addition, the six measures of satisfaction were lower (P < 0.001) in patients who perceived their stays as too short. However, the hypothesized lower satisfaction in patients with shorter stays was not observed; differences in satisfaction according to length of stay were small and of questionable practical significance.
The findings suggest that patients' satisfaction with obstetric care may not depend on the absolute duration of stay but rather on whether patients perceive the length of stay to be adequate. The results are timely because of recent legislation that mandates minimum hospital stays for labor and delivery.
探讨患者对医院产科护理的满意度、住院时间以及患者对住院时间合理性的认知之间的关系。
一项横断面研究。
我们对1992年至1994年期间在一个大城市地区18家医院分娩后出院的27789名女性进行了调查（回复率为58%）。使用患者评判系统评估患者满意度，该系统是一种先前已验证的工具。我们的分析集中在评估护理具体方面的四个量表（医生护理、护理、信息提供和出院准备）以及两个满意度单项指标（总体质量和返回医院的意愿）。
住院时间较短的患者更有可能（P < 0.001）认为自己的住院时间“太短”。此外，认为住院时间太短的患者的六项满意度指标较低（P < 0.001）。然而，未观察到住院时间较短的患者满意度较低的假设情况；根据住院时间的满意度差异较小且实际意义存疑。
研究结果表明，患者对产科护理的满意度可能不取决于住院的绝对时长，而是取决于患者是否认为住院时间足够。由于最近有立法规定分娩的最短住院时间，这些结果很及时。
