Ganova-Iolovska Milka, Kalinov Krassimir, Geraedts Max
National Center of Public Health Protection, 15, Ivan Ev, Geshov Blvd, 1341, Sofia, Bulgaria.
Health Qual Life Outcomes. 2008 Jul 14;6:50. doi: 10.1186/1477-7525-6-50.
Patient satisfaction constitutes an important indicator for the quality of care. During the last years, Bulgaria changed its socialist health care system to a market-driven system. Despite the fact that the improvement of health care quality and patient satisfaction were put on top of the list of goals for the health care reforms, no studies of patient satisfaction with inpatient care have been conducted so far.Since cardiovascular diseases are amongst the major causes of death in Bulgaria, and strenuous efforts have been made to improve the quality of medical care of patients with acute coronary syndrome (ACS) during the last years, patient satisfaction in this group can be seen as an important example of the Bulgarian reforms. This study therefore investigates patient satisfaction of inpatients with ACS.
We performed structured face-to-face interviews with all patients with ACS, residing in a representative Bulgarian region who were discharged from hospitals in this region between September 1st and December 31st, 2004. We surveyed their socio-demographic status, overall satisfaction, change in complaints, self-perceived health status, functional possibilities in activities of daily living, satisfaction with life and self-reported condition at admission. We used descriptive methods as well as t-tests, chi-square tests, and logit models for data analysis.
Face-to-face interviews were carried out in 394 cases, of which 53.6% were men and 46.4% were women. 24% of the patients were satisfied with inhospital treatment, 62% were satisfied to some extent, and 14% were unsatisfied. The overall satisfaction of patients with ACS was significantly associated (p < 0.05) with the type of hospital, the number of family members living together and the severity of the disease at admission. Patients treated in urban and middle-size rural hospitals, patients living together with three or more family members, and patients with more severe conditions at admission reported higher satisfaction scores.
ACS patient satisfaction with inhospital treatment in Bulgaria shows much room for improvement. Information obtained from satisfaction studies could be used at decision-making and hospital-management levels for improving new strategies and structural changes in the Bulgarian health care system.
患者满意度是医疗质量的一项重要指标。在过去几年中，保加利亚将其社会主义医疗体系转变为市场驱动型体系。尽管医疗质量的提升和患者满意度被置于医疗改革目标的首位，但迄今为止尚未开展关于住院患者满意度的研究。由于心血管疾病是保加利亚主要死因之一，且在过去几年中已作出巨大努力来提高急性冠状动脉综合征（ACS）患者的医疗质量，该群体的患者满意度可视作保加利亚改革的一个重要范例。因此，本研究调查了ACS住院患者的满意度。
我们对居住在保加利亚一个具有代表性地区、于2004年9月1日至12月31日期间从该地区医院出院的所有ACS患者进行了结构化面对面访谈。我们调查了他们的社会人口统计学状况、总体满意度、投诉变化、自我感知的健康状况、日常生活活动中的功能能力、生活满意度以及入院时自我报告的病情。我们使用描述性方法以及t检验、卡方检验和逻辑模型进行数据分析。
共对394例患者进行了面对面访谈，其中53.6%为男性，46.4%为女性。24%的患者对住院治疗满意，62%在一定程度上满意，14%不满意。ACS患者的总体满意度与医院类型、共同居住的家庭成员数量以及入院时疾病的严重程度显著相关（p < 0.05）。在城市和中型农村医院接受治疗的患者、与三名或更多家庭成员共同居住的患者以及入院时病情更严重的患者报告的满意度得分更高。
保加利亚ACS患者对住院治疗的满意度有很大的提升空间。从满意度研究中获得的信息可用于决策和医院管理层面，以改进保加利亚医疗体系的新策略和结构变革。
