Fong Ronald L, Bertakis Klea D, Franks Peter
Department of Family and Community Medicine, University of California, 4680 Y Street, Suite 2300, Sacramento, CA 95817, USA.
Obesity (Silver Spring). 2006 Aug;14(8):1402-11. doi: 10.1038/oby.2006.159.
To examine the relationship between BMI and patient satisfaction with health care providers using a nationally representative survey.
This analysis examined the 9914 adult patients who completed the 2000 Medical Expenditure Panel Survey and had visited a health care provider within 12 months of the survey. Linear regression models were employed with patient satisfaction as the dependent variable. The patient satisfaction scale was based on ratings from five questions assessing the quality of provider interactions. The independent variable was BMI, with adjustments for the domains of demographics, social-economic status, health attitudes and behavior, health status, and health care use. BMI (weight in kilograms/square of height in meters) was classified as normal weight (18.5 to 24.9), overweight (25.0 to 29.9), or obese (>or=30.0). Hierarchical models were used to evaluate how each domain modified the BMI-satisfaction association.
Obese patients reported significantly greater satisfaction with their health care providers than their normal-weight counterparts did (p < 0.05). There were no significant differences in satisfaction between normal-weight and overweight patients or between overweight and obese patients. The health status domain produced the largest modification in the BMI-satisfaction relationship. Examination of interaction effects revealed that the association between BMI and satisfaction was confined to older persons.
In this nationally representative sample of individuals, obese persons were more satisfied than their normal-weight counterparts. This finding counters those of previous studies. Incomplete adjustments for health care use and insurance status may have led to those conclusions.
通过一项具有全国代表性的调查,研究体重指数(BMI)与患者对医疗服务提供者满意度之间的关系。
本分析考察了9914名成年患者,这些患者完成了2000年医疗支出小组调查,且在调查前12个月内拜访过医疗服务提供者。采用线性回归模型,将患者满意度作为因变量。患者满意度量表基于五个评估医疗服务提供者互动质量问题的评分。自变量为BMI,并对人口统计学、社会经济地位、健康态度与行为、健康状况以及医疗服务使用等领域进行了调整。BMI(体重千克数/身高米数的平方)被分类为正常体重(18.5至24.9)、超重(25.0至29.9)或肥胖(≥30.0)。使用分层模型来评估每个领域如何改变BMI与满意度之间的关联。
肥胖患者对医疗服务提供者的满意度显著高于正常体重的患者(p<0.05)。正常体重与超重患者之间或超重与肥胖患者之间的满意度没有显著差异。健康状况领域对BMI与满意度之间的关系产生了最大的改变。对交互效应的检验表明,BMI与满意度之间的关联仅限于老年人。
在这个具有全国代表性的样本中,肥胖者比正常体重者更满意。这一发现与先前的研究结果相反。对医疗服务使用和保险状况的不完全调整可能导致了那些结论。