Otani Koichiro, Kurz Richard S
School of Public and Environmental Affairs, Indiana University-Purdue University, Fort Wayne, Indiana, USA.
J Healthc Manag. 2004 May-Jun;49(3):181-96; discussion 196-7.
Healthcare organizations in the United States are struggling to find ways to survive in their uncertain and competitive environments. One of the survival strategies used by those organizations is to increase patient satisfaction. This article presents research on factors that influence hospitalized patients' satisfaction and their intention to return to and recommend the hospital. The first objective of this study was to find out, using a comprehensive set of healthcare attributes, which attributes play a more important role in increasing patient satisfaction and behavioral intentions. The second objective was to analyze the relative importance of those attributes and the nature of the relationships across the values of the attributes. More specifically, this study attempted to identify any existing curvilinear relationships among these variables. If any curvilinear relationships exist, do they show an increasing or a decreasing marginal-utility function? Included in this article is an example, featuring a hospital-discharged patient, that explains the importance and uniqueness of this curvilinear relationship. This study found that among six attributes, nursing care showed the largest parameter estimate for the patient satisfaction and behavioral intentions models. Thus, simply improving the nursing care attribute seems to be the most effective manner to enhancing patient satisfaction and behavioral intentions. However, nursing care also showed a diminishing marginal-utility function for both models. To assess the effect of this diminishing marginal-utility function, the impact of nursing care was computed for each unit of improvement together with other attributes. The finding from this study provides information needed to increase patient satisfaction and behavioral intentions and should result in more effective and efficient healthcare management.
美国的医疗保健机构正在努力寻找在不确定和竞争激烈的环境中生存的方法。这些机构采用的一种生存策略是提高患者满意度。本文介绍了关于影响住院患者满意度及其再次就诊意愿和推荐医院意愿的因素的研究。本研究的第一个目标是，通过一套全面的医疗保健属性，找出哪些属性在提高患者满意度和行为意愿方面发挥更重要的作用。第二个目标是分析这些属性的相对重要性以及属性值之间关系的性质。更具体地说，本研究试图确定这些变量之间是否存在任何现有的曲线关系。如果存在任何曲线关系，它们是呈现边际效用递增函数还是递减函数？本文包含一个以出院患者为例的内容，解释了这种曲线关系的重要性和独特性。本研究发现，在六个属性中，护理在患者满意度和行为意愿模型中显示出最大的参数估计值。因此，简单地改善护理属性似乎是提高患者满意度和行为意愿的最有效方式。然而，护理在两个模型中也显示出边际效用递减函数。为了评估这种边际效用递减函数的影响，计算了护理每提高一个单位与其他属性一起产生的影响。本研究的结果提供了提高患者满意度和行为意愿所需的信息，应该会带来更有效和高效的医疗管理。
