Oz M C, Zikria J, Mutrie C, Slater J P, Scott C, Lehman S, Connolly M W, Asher D T, Ting W, Namerow P B
Columbia University, College of Physicians and Surgeons, New York, New York, USA.
Heart Surg Forum. 2001;4(2):166-71.
A means of measuring patient satisfaction is essential in the effort to improve the quality of health care delivered in our nation's hospitals. Accurate feedback allows employers to better meet patients' needs and allows hospital administrators to improve service delivery. Patients are empowered by having a voice in the manner in which their health care is delivered. Moreover, improving the efficiency of the health care delivery system decreases health care costs. Hospital comparisons can be made readily available to a large audience through the Internet, resulting in empowerment of the patient and a universal improvement in hospital care. This is the first multi-institutional analysis of patient satisfaction among New York City and northern New Jersey area tertiary care hospitals. In this study, we evaluated the patient-assessed hotel function of hospitals in a single geographic region to determine whether clinically and statistically significant differences would be revealed that could provide beneficial information to stakeholders in the healthcare system.
Patients (n = 261) who had spent a night during the past year in one of eleven hospitals within 60 miles of New York City were chosen at random from doctors' waiting rooms. On average, 24 patients from each hospital were surveyed. They were asked to complete a questionnaire that rated the various departments in the hospital on qualities such as courtesy, promptness, and cleanliness. The questionnaire also rated important characteristics of the patient experience, such as the ease of parking and the taste of the food. Each item on the survey was coded on a scale of 1 to 10 with 10 being the most positive response. The 26 specific questions were divided into 14 domains. Averages in each domain were compared by gender, age, and hospital identity, attractiveness, and setting. All statistical calculations were performed using SPSS/PC, and means were compared using t-tests.
Analysis designed to evaluate outcomes between each of the possible 54 pairs of hospitals comparisons revealed statistically significant differences as often as 44% of the time in some outcomes measures (logistics), but as rarely as 7% of the time in others (billing function). Clinically significant differences (>2 units per scale) were frequently evident, although the ranges differed dramatically depending on the domains surveyed. Although age, gender, and race/ethnicity were generally not predictive of satisfaction, non-urban setting was correlated with greater patient satisfaction.
By having access to patient satisfaction comparisons among hospitals, patients are empowered to make better choices, employers can identify and adapt to patient preferences, and administrators can improve the services delivered and decrease health care costs by improving efficiency. Although our study was somewhat limited by patient selection biases, the study's results suggest that Internet-based tools of comparison will enable patients to make free and informed decisions about their health care by comparing local hospitals and voting on their impressions of the facilities from which they receive care.
在努力提高我国医院提供的医疗服务质量的过程中，一种衡量患者满意度的方法至关重要。准确的反馈能使医疗机构更好地满足患者需求，也能让医院管理人员改进服务提供。患者在其医疗服务的提供方式上拥有发言权，从而获得了权力。此外，提高医疗服务系统的效率可降低医疗成本。通过互联网，医院比较结果能够很容易地提供给广大受众，从而增强患者的权力，并普遍改善医院护理水平。这是对纽约市和新泽西州北部地区三级护理医院患者满意度进行的首次多机构分析。在本研究中，我们评估了单一地理区域内医院的患者评估的酒店功能，以确定是否会揭示出具有临床和统计学意义的差异，从而为医疗保健系统中的利益相关者提供有益信息。
从纽约市60英里范围内的11家医院中，在过去一年里曾在其中一家医院住过一晚的患者（n = 261），从医生候诊室中随机选取。平均每家医院调查24名患者。他们被要求完成一份问卷，对医院的各个科室在礼貌、及时性和清洁等方面进行评分。问卷还对患者体验的重要特征进行评分，如停车便利性和食物口味。调查问卷上的每个项目按1至10分进行编码，10分为最积极的回答。26个具体问题分为14个领域。通过性别、年龄、医院身份、吸引力和环境对每个领域的平均值进行比较。所有统计计算均使用SPSS/PC进行，均值比较使用t检验。
旨在评估每对可能的54组医院比较之间结果的分析显示，在某些结果指标（后勤）中，高达44%的时间存在统计学显著差异，但在其他指标（计费功能）中，低至7%的时间存在差异。临床上显著的差异（每量表>2个单位）经常很明显，尽管差异范围因所调查的领域而有很大不同。虽然年龄、性别和种族/族裔通常不能预测满意度，但非城市环境与更高的患者满意度相关。
通过获取医院之间的患者满意度比较结果，患者能够做出更好的选择，医疗机构能够识别并适应患者偏好，管理人员能够通过提高效率来改善提供的服务并降低医疗成本。尽管我们的研究在一定程度上受到患者选择偏差的限制，但研究结果表明，基于互联网的比较工具将使患者能够通过比较当地医院并对他们接受护理的设施印象进行投票，从而对自己的医疗保健做出自由和明智的决定。
