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家庭医疗诊所中的连续性护理与患者满意度

Continuity of care and patient satisfaction in a family practice clinic.

作者信息

Morgan Eric D, Pasquarella Michael, Holman John R

机构信息

Department of Family Practice, Dwight D. Eisenhower Medical Center, Fort Gordon, GA, USA.

出版信息

J Am Board Fam Pract. 2004 Sep-Oct;17(5):341-6. doi: 10.3122/jabfm.17.5.341.

Abstract

BACKGROUND

Continuity is a tenant central to family practice. Continuity is associated with improved satisfaction in populations that can easily change providers. However, little is known about the importance of continuity where patients are assigned providers.

METHODS

A pretested survey was distributed to patients of a family practice residency clinic in a military medical center for a week's period. Results were analyzed using chi2, unpaired t test, correlation matrices, and linear regression for patient satisfaction.

RESULTS

The response rate was 68.3%. Responders were not more likely to be seeing their primary care provider (PCP). Regression analysis revealed that 12% of patient satisfaction was associated with long-term continuity rates, 23% by PCP satisfaction, and 17% by how easy it was to make the appointment. For high clinic users (>10 visits/year), 78% of patient satisfaction is determined by PCP satisfaction and long-term continuity rates. A subset of patients (13%) values choice of appointment time or other providers over PCP continuity. Satisfaction is not diminished in this group despite low long-term continuity (P <.05 for all results).

CONCLUSIONS

Patient satisfaction is associated with continuity, especially for high clinic users. Although continuity is important, a subset of patients values the ability to see other providers and to change providers.

摘要

背景

连续性是家庭医疗的核心要素。在患者可以轻松更换医疗服务提供者的人群中,连续性与更高的满意度相关。然而,对于在患者被分配医疗服务提供者的情况下连续性的重要性,我们知之甚少。

方法

在一家军事医疗中心的家庭医疗住院诊所,对患者进行了为期一周的预测试调查。使用卡方检验、非配对t检验、相关矩阵和线性回归分析患者满意度结果。

结果

回复率为68.3%。回复者看其初级保健提供者(PCP)的可能性并不更高。回归分析显示,患者满意度的12%与长期连续性率相关,23%与PCP满意度相关,17%与预约的难易程度相关。对于高就诊量患者(每年就诊>10次),患者满意度的78%由PCP满意度和长期连续性率决定。一小部分患者(13%)更看重预约时间的选择或看其他医疗服务提供者,而非PCP的连续性。尽管长期连续性较低,但该组患者的满意度并未降低(所有结果P<.05)。

结论

患者满意度与连续性相关,尤其是对于高就诊量患者。虽然连续性很重要,但一小部分患者看重看其他医疗服务提供者和更换医疗服务提供者的能力。

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