Rosemann Thomas, Wensing Michel, Szecsenyi Joachim, Grol Richard
Department of General Practice, University Hospital Zürich, Zürich, Switzerland.
J Eval Clin Pract. 2009 Jun;15(3):486-91. doi: 10.1111/j.1365-2753.2008.01047.x. Epub 2009 Apr 7.
Osteoarthritis (OA) has a high prevalence in primary care. Patient satisfaction is an important indicator for the quality of care provided to OA patients. Little is known about satisfaction of patients with this condition in a primary care setting in Germany. The aim of the study was to assess current satisfaction of patients and reveal possible disease and quality of life related predictors.
METHODS/DESIGN: Seventy-five German GPs approached 1250 patients with OA consecutively. Sociodemographics, OA-specific quality of life (GERMAN-AIMS2-SF), co-morbidities and depression (using PHQ-9) were assessed. Patient satisfaction was measured by means of the European Task Force on Patient Evaluations of General Practice (EUROPEP) instrument. A stepwise linear regression analysis with the EUROPEP score as dependent variable controlled for the amount of GP visits was performed to assess predictors of satisfaction.
A total of 1021 OA patients returned the questionnaire. The adjusted R(2) of the final model was 0.270 (P < 0.001). The main predictors were the PHQ-9 score (beta = -0.372; P < 0.001), age (beta = -0.185; P < 0.001), living alone (beta = -0.209; P < 0.001) and number of co-morbidities (beta = -0.152; P < 0.001). The only disease-related factor which remained as predictor of patient satisfaction was duration of OA (beta = -0.105; P = 0.008).
The finding that depression and social factors are more important for patient satisfaction with provided care than disease-related aspects suggests that these factors need to be considered carefully in treatment. This represents a big challenge within an increasingly specialized health care system. The General Practitioner as the regular and first-choice provider of health care seems to be the most appropriate instance who can accomplish this.
骨关节炎(OA)在初级保健中具有较高的患病率。患者满意度是为OA患者提供护理质量的重要指标。在德国的初级保健环境中,对于患有这种疾病的患者的满意度了解甚少。该研究的目的是评估患者当前的满意度,并揭示可能与疾病和生活质量相关的预测因素。
方法/设计:75名德国全科医生连续接触了1250名OA患者。评估了社会人口统计学、OA特定生活质量(GERMAN - AIMS2 - SF)、合并症和抑郁(使用PHQ - 9)情况。患者满意度通过欧洲全科医疗患者评估特别工作组(EUROPEP)工具进行测量。以EUROPEP评分作为因变量,对全科医生就诊次数进行控制,进行逐步线性回归分析以评估满意度的预测因素。
共有1021名OA患者返回了问卷。最终模型的调整R²为0.270(P < 0.001)。主要预测因素为PHQ - 9评分(β = -0.372;P < 0.001)、年龄(β = -0.185;P < 0.001)、独居(β = -0.209;P < 0.001)和合并症数量(β = -0.152;P < 0.001)。唯一作为患者满意度预测因素保留的疾病相关因素是OA病程(β = -0.105;P = 0.008)。
抑郁和社会因素对患者对所提供护理的满意度比疾病相关方面更重要这一发现表明,在治疗中需要仔细考虑这些因素。在日益专业化的医疗保健系统中,这是一个巨大的挑战。全科医生作为常规且首选的医疗保健提供者似乎是能够做到这一点的最合适人选。