Howard Michelle, Goertzen James, Hutchison Brian, Kaczorowski Janusz, Morris Kelly
Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.
Ann Fam Med. 2007 Sep-Oct;5(5):419-24. doi: 10.1370/afm.704.
Patient satisfaction is an important health care outcome. This study compared patients' satisfaction with care received for an urgent health problem from their family physician, at an after-hours clinic in which their physician participated, at a walk-in clinic, at the emergency department, from telephone health advisory services, or from more than 1 of those services.
We mailed a questionnaire to a random sample of patients from 36 family practices in Thunder Bay, Ontario. We elicited satisfaction with care for the most recent urgent health problem in the past 6 months on a 7-point scale (very dissatisfied to very satisfied).
The response rate was 62.3% (5,884 of 9,397). Of the 5,722 eligible patients 1,342 (23.4%) reported an urgent health problem, and data were available for both services used and satisfaction for 1,227 patients. After adjusting for sociodemographic characteristics and self-reported health status, satisfaction with care received for most recent urgent health problem was significantly higher among patients who visited or spoke to their family physician (mean 6.1; 95% confidence interval [CI], 5.8-6.4) compared with all other services (all P <.004, adjusted for multiple comparisons), with the exception of patients who used the after-hours clinic affiliated with their physician, whose satisfaction was not significantly different (mean 5.6; 95% CI, 5.2-6.0).
Satisfaction was highest for patients receiving care from their own family physician or their physician's after-hours clinic. These results are important for new primary care models that emphasize continuity and after-hours availability of family physicians.
患者满意度是一项重要的医疗保健成果。本研究比较了患者对因紧急健康问题从其家庭医生处、其医生参与的夜间诊所、随诊诊所、急诊科、电话健康咨询服务或上述多种服务中获得的护理的满意度。
我们向安大略省桑德贝市36个家庭医疗诊所的患者随机样本邮寄了一份问卷。我们采用7分制（从非常不满意到非常满意）来了解患者对过去6个月内最近一次紧急健康问题护理的满意度。
回复率为62.3%（9397名患者中的5884名）。在5722名符合条件的患者中，1342名（23.4%）报告有紧急健康问题，1227名患者既有使用服务的数据，也有满意度数据。在调整了社会人口学特征和自我报告的健康状况后，与所有其他服务相比（经多重比较调整后，所有P<.004），拜访或与家庭医生交谈的患者对最近一次紧急健康问题护理的满意度显著更高（平均6.1；95%置信区间[CI]，5.8 - 6.4），使用其医生所属夜间诊所的患者除外，其满意度无显著差异（平均5.6；95%CI，5.2 - 6.0）。
从自己的家庭医生或其医生的夜间诊所接受护理的患者满意度最高。这些结果对于强调家庭医生连续性和夜间可用性的新型初级保健模式很重要。
