Narayan K M Venkat, Gregg Edward W, Fagot-Campagna Anne, Gary Tiffany L, Saaddine Jinan B, Parker Corette, Imperatore Giuseppina, Valdez Rodolfo, Beckles Gloria, Engelgau Michael M
Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
J Natl Med Assoc. 2003 Jan;95(1):64-70.
Patient satisfaction is regarded as a component of the quality of medical care. We examined the association between quality of care and patient satisfaction.
Cross-sectional study.
Population-based random sample in North Carolina, United States, 1997.
591 African-Americans aged > or = 18 years with self-reported diabetes were interviewed for providers' delivery of 10 preventive measures and patients' performance of four preventive measures for diabetes care.
Satisfaction with health care providers with respect to 11 items, on a 4-point scale (excellent, good, fair, and poor). Average satisfaction scores were compared according to levels of quality of care.
Patient satisfaction was positively associated with income, employment, diabetes education, ease of getting care during the last year, having health care coverage and having one physician for diabetes care (P < 0.05 for each). Adjusted for age, sex, education, employment, and income, 8 of 10 preventive care practices by providers during the previous year--monitoring of concentrations of glycosylated hemoglobin (HbA1c) and cholesterol; performing eye, foot, and gum examinations; and physician counseling on self-monitoring of blood glucose concentrations, exercise, and weight reduction--were associated with higher satisfaction scores (P < 0.05). Patients' performance of three of four preventive practices--taking medications for diabetes as prescribed, performing daily self-examination of the feet, and going for an eye examination with dilation of the pupils--were also associated with higher satisfaction scores (P < 0.05).
Quality of diabetes care was positively associated with patient satisfaction with provider of care. Prospective studies are needed to confirm this association and its direction.
患者满意度被视为医疗服务质量的一个组成部分。我们研究了医疗服务质量与患者满意度之间的关联。
横断面研究。
1997年在美国北卡罗来纳州进行的基于人群的随机抽样。
591名年龄≥18岁且自我报告患有糖尿病的非裔美国人，就医疗服务提供者提供的10项预防措施以及患者为糖尿病护理所采取的4项预防措施接受了访谈。
对医疗服务提供者在11个项目上的满意度，采用4分制（优秀、良好、一般、差）。根据医疗服务质量水平比较平均满意度得分。
患者满意度与收入、就业、糖尿病教育、过去一年获得医疗服务的难易程度、拥有医疗保险以及有一位负责糖尿病护理的医生呈正相关（每项P<0.05）。在对年龄、性别、教育程度、就业和收入进行调整后，前一年医疗服务提供者实施的10项预防保健措施中的8项——监测糖化血红蛋白（HbA1c）和胆固醇浓度；进行眼部、足部和牙龈检查；以及医生就血糖浓度自我监测、运动和减重进行咨询——与更高的满意度得分相关（P<0.05）。患者采取的4项预防措施中的3项——按处方服用糖尿病药物、每天进行足部自我检查以及进行散瞳眼部检查——也与更高的满意度得分相关（P<0.05）。
糖尿病护理质量与患者对医疗服务提供者的满意度呈正相关。需要进行前瞻性研究来证实这种关联及其方向。
