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日本参加公共保险的精神科门诊患者满意吗?

Are publicly-insured psychiatric outpatients in Japan satisfied?

作者信息

Ito H, Sederer L I

机构信息

Department of Health Care Economics, National Institute of Health Services Management, 1-23-1 Toyama, Shinjuku-ku, 162-0052, Tokyo, Japan.

出版信息

Health Policy. 2001 Jun;56(3):205-13. doi: 10.1016/s0168-8510(01)00116-6.

Abstract

Japan has a government financed outpatient program for people with mental disorders, called the 'publicly-insured' program. This study was performed to examine whether the target patient population used this publicly-insured program properly and to compare the degree of satisfaction of publicly-insured psychiatric outpatients with generally-insured psychiatric outpatients. The characteristics and satisfaction of 97 (43.9%) publicly-insured psychiatric outpatients and 124 (55.1%) generally-insured outpatients in Japan were studied. Psychiatrists rated sociodemographic and diagnostic information and patients were asked to complete the Japanese version of Client Satisfaction Questionnaire (CSQ-8J). The publicly-insured were longer-term and lower functioning patients and were significantly more dissatisfied with the services they received than the generally-insured patients. The publicly-insured program was successful in that patients with lower functioning (the primary target population of this program) were cared for and because they received treatment for longer periods of time. However, the program does not sufficiently satisfy the consumers of the services, despite its high costs. In this respect, this program needs to focus more on patients' points of view. More information on programs their enrollment procedures for patients may be helpful in educating consumers and citizens, clarifying expectations of services, and in influencing satisfaction.

摘要

日本为精神障碍患者设有一项由政府资助的门诊项目,称为“公共保险”项目。本研究旨在调查目标患者群体是否正确使用了该公共保险项目,并比较公共保险的精神科门诊患者与一般保险的精神科门诊患者的满意度。对日本97名(43.9%)公共保险的精神科门诊患者和124名(55.1%)一般保险的门诊患者的特征及满意度进行了研究。精神科医生对社会人口统计学和诊断信息进行了评分,并要求患者填写日文版的客户满意度调查问卷(CSQ - 8J)。公共保险患者病程更长、功能更低,与一般保险患者相比,他们对所接受服务的不满程度明显更高。公共保险项目取得了成功,因为功能较低的患者(该项目的主要目标群体)得到了照料,且他们接受治疗的时间更长。然而,尽管成本高昂,该项目并未充分满足服务消费者的需求。在这方面,该项目需要更多地关注患者的观点。提供更多关于项目及其患者登记程序的信息,可能有助于教育消费者和公民,明确对服务的期望,并影响满意度。

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