Jennings B M, Loan L A
US Army Nurse Corps, Falls Church, Virginia, USA.
J Nurs Adm. 1999 Nov;29(11):47-55. doi: 10.1097/00005110-199911000-00011.
A study was performed to evaluate military beneficiaries' motivation for choosing to change from a civilian managed care system to the military managed care system.
Concerns about healthcare cost, quality, and access underpin major reform in military healthcare. The military health system (MHS) is implementing managed care through an initiative known as TRICARE. Patient choice and satisfaction are highly relevant to all healthcare delivery systems; they are being explored aggressively in the MHS as TRICARE evolves.
This descriptive study was conducted using a telephone survey consisting of 63 items derived from four pre-existing instruments as well as five facility-specific questions and demographics. The population of interest targeted military beneficiaries on a TRICARE waiting list who, at the time of enrollment, indicated a desire to receive care at the military facility.
Consumers were inclined to return to the military system because of loyalty. Also, this study provided evidence that staff courtesy is important to those who seek healthcare. Good quality and accessibility were verified as essential elements in sustaining a consumer's positive view of and attraction to a particular healthcare system. Cost was proven to be a less substantial factor of consumer decision making.
Surveys such as this give healthcare providers more information about aspects of care, such as patient loyalty and interpersonal dynamics, that attract people to their healthcare delivery systems. For healthcare systems to thrive, consumer influence and the power of patient dissatisfaction must be understood.
开展一项研究以评估军队医疗受益者选择从民用管理式医疗系统转变为军队管理式医疗系统的动机。
对医疗成本、质量和可及性的担忧是军队医疗重大改革的基础。军队卫生系统（MHS）正在通过一项名为“特里卡尔”（TRICARE）的倡议实施管理式医疗。患者选择和满意度与所有医疗服务提供系统高度相关；随着“特里卡尔”的发展，MHS正在积极探索这些方面。
本描述性研究采用电话调查进行，该调查由源自四项现有工具的63个项目以及五个特定机构问题和人口统计学问题组成。研究对象为在“特里卡尔”等候名单上的军队医疗受益者，他们在登记时表示希望在军队医疗机构接受治疗。
消费者因忠诚度而倾向于回归军队系统。此外，本研究提供的证据表明，工作人员的礼貌对寻求医疗服务的人很重要。高质量和可及性被证实是维持消费者对特定医疗系统的积极看法和吸引力的关键因素。成本被证明是消费者决策中不太重要的因素。
这样的调查能让医疗服务提供者更多地了解吸引人们选择其医疗服务提供系统的护理方面的信息，比如患者忠诚度和人际动态。为使医疗系统蓬勃发展，必须了解消费者的影响以及患者不满的影响力。
