Kerr Eve A, Smith Dylan M, Kaplan Sherrie H, Hayward Rodney A
VA Center for Practice Management and Outcomes Research and University of Michigan School of Medicine, USA.
Med Care Res Rev. 2003 Jun;60(2):158-77. doi: 10.1177/1077558703060002002.
Studies suggest that health status influences patient satisfaction, but little work has examined the influence of different measures of health status on satisfaction. The authors examined whether the association between health status and satisfaction varied for different measures of health status among 2000 diabetic patients receiving care across 25 Veterans Affairs facilities. Health status was measured using (1) the diabetes-related components of the Total Illness Burden Index (DM TIBI), a measure of diabetes severity and comorbidities; (2) the Short Form 36 (SF-36) Physical Function Index (PFI10); and (3) the SF-36 general health perceptions question (SF-1). Satisfaction was measured both by a 5-item scale on satisfaction with patient-provider communication and by a single item on overall diabetes care satisfaction. In adjusted models, worse health on all three health status measures correlated with lower satisfaction, but the DM TIBI explained more of the variation in satisfaction than either the PFI10 or SF-1. Moreover, when the DM TIBI was added to the model containing PFI10, PFI10 was no longer significantly associated with satisfaction. In this diabetes population, health status appears to have a substantial impact on patient satisfaction, and this effect is considerably greater for diabetes severity than for physical functioning.
研究表明健康状况会影响患者满意度,但很少有研究探讨不同健康状况衡量指标对满意度的影响。作者调查了2000名在25个退伍军人事务机构接受治疗的糖尿病患者中,不同健康状况衡量指标下健康状况与满意度之间的关联是否存在差异。健康状况通过以下方式衡量:(1)总疾病负担指数(DM TIBI)中与糖尿病相关的部分,这是一种衡量糖尿病严重程度和合并症的指标;(2)简短健康调查问卷(SF - 36)身体功能指数(PFI10);以及(3)SF - 36一般健康感知问题(SF - 1)。满意度通过一份关于患者与医护人员沟通满意度的5项量表以及一项关于总体糖尿病护理满意度的单项指标来衡量。在调整后的模型中,所有三项健康状况衡量指标显示,健康状况越差与满意度越低相关,但DM TIBI比PFI10或SF - 1能解释更多的满意度差异。此外,当将DM TIBI添加到包含PFI10的模型中时,PFI10与满意度不再显著相关。在这个糖尿病患者群体中,健康状况似乎对患者满意度有重大影响,而且这种影响在糖尿病严重程度方面比身体功能方面要大得多。