Lin C T, Albertson G A, Schilling L M, Cyran E M, Anderson S N, Ware L, Anderson R J
Division of General Internal Medicine, Department of Medicine, University of Colorado Health Sciences Center, 4200 E Ninth Ave, Denver, CO 80262, USA.
Arch Intern Med. 2001 Jun 11;161(11):1437-42. doi: 10.1001/archinte.161.11.1437.
Time management in ambulatory patient visits is increasingly critical. Do patients who perceive a longer visit with internists report increased satisfaction?
Prospective survey of 1486 consecutively encountered ambulatory visits to 16 primary care physicians (PCPs) in an academic primary care clinic. Patients were queried regarding demographics, health status, perception of time spent before and after ambulatory visits, whether the physician appeared rushed, and visit satisfaction. Physicians were queried regarding time spent, estimated patient satisfaction, and whether they felt rushed.
In 69% of 1486 consecutive visits, patient previsit expectation of visit duration was 20 minutes or less. Patient and PCP postvisit estimates of time spent significantly exceeded patient previsit time expectation. Patients who estimated that they spent more time than expected with the PCP were significantly more satisfied with the visit. When patient postvisit estimate of time spent was less than the previsit expectation, visit satisfaction was significantly lower independent of time spent. Patient worry about health and lower self-perceived health status were significantly associated with patient expectation for longer visits. Primary care physicians felt rushed in 10% of encounters. Although PCPs estimated patient satisfaction was significantly lower when they felt rushed, patient satisfaction was identical when PCPs did and did not feel rushed. Patients indicated that PCPs appeared rushed in 3% of encounters, but this perception did not affect patient satisfaction.
Perceived ambulatory visit duration and meeting or exceeding patient expectation of time needed to be spent with the physician are determinants of patient satisfaction in an ambulatory internal medicine practice.
门诊患者就诊时的时间管理日益关键。那些认为与内科医生就诊时间较长的患者报告的满意度会提高吗?
对一家学术性初级保健诊所的16位初级保健医生(PCP)连续接诊的1486例门诊患者进行前瞻性调查。询问患者的人口统计学特征、健康状况、对门诊就诊前后所花费时间的感知、医生是否显得匆忙以及就诊满意度。询问医生所花费的时间、估计的患者满意度以及他们是否感到匆忙。
在1486例连续就诊中,69%的患者就诊前预期就诊时长为20分钟或更短。患者和初级保健医生就诊后对所花费时间的估计显著超过患者就诊前的时间预期。那些估计自己与初级保健医生相处的时间比预期长的患者对就诊的满意度显著更高。当患者就诊后对所花费时间的估计低于就诊前预期时,无论实际花费时间长短,就诊满意度均显著较低。患者对健康的担忧和较低的自我感知健康状况与患者对更长就诊时间的预期显著相关。初级保健医生在10%的接诊中感到匆忙。尽管初级保健医生感到匆忙时估计的患者满意度显著较低,但初级保健医生感到匆忙和不匆忙时患者满意度相同。患者表示在3%的接诊中初级保健医生显得匆忙,但这种感知并未影响患者满意度。
在门诊内科实践中,感知到的门诊就诊时长以及达到或超过患者对与医生相处所需时间的预期是患者满意度的决定因素。