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患者满意度是否受其医生医疗资源使用强度的影响?

Is patient satisfaction influenced by the intensity of medical resource use by their physicians?

作者信息

Dowd Bryan E, Kralewski John E, Kaissi Amer A, Irrgang Sally J

机构信息

Division of Health Policy and Management, University of Minnesota, Minneapolis, MN 55455, USA.

出版信息

Am J Manag Care. 2009 May 1;15(5):e16-21.

Abstract

OBJECTIVE

To determine whether patients' satisfaction with their primary care is related to providers' use of medical resources.

STUDY DESIGN

Sixty-two practices serving 2805 patients enrolled in BlueCross BlueShield of Minnesota were analyzed using hierarchical regression models.

METHODS

Three measures of satisfaction included patient satisfaction with overall healthcare, patient satisfaction with the time spent with a physician or other provider during a visit, and the likelihood that a patient would recommend the clinic to others.

RESULTS

Patient satisfaction was found to be primarily a function of patient characteristics and not of practice characteristics. Providers' use of medical resources was not significantly related to patients' overall ratings of healthcare or to patients' willingness to recommend the practice to others. However, the time spent with a physician or other provider was significantly negatively related to patient satisfaction. Physician workload was significantly related to patient satisfaction.

CONCLUSIONS

To improve patient satisfaction, practices should focus on reducing physician workload. Valid measures of patient satisfaction must correct for the strong effects of patient characteristics.

摘要

目的

确定患者对初级保健的满意度是否与医疗服务提供者对医疗资源的使用有关。

研究设计

使用分层回归模型分析了明尼苏达州蓝十字蓝盾公司的62家诊所,这些诊所服务于2805名患者。

方法

满意度的三项指标包括患者对整体医疗保健的满意度、患者对就诊期间与医生或其他医疗服务提供者相处时间的满意度,以及患者向他人推荐诊所的可能性。

结果

发现患者满意度主要取决于患者特征,而非诊所特征。医疗服务提供者对医疗资源的使用与患者对医疗保健的总体评分或患者向他人推荐该诊所的意愿没有显著关系。然而,与医生或其他医疗服务提供者相处的时间与患者满意度显著负相关。医生工作量与患者满意度显著相关。

结论

为提高患者满意度,诊所应专注于减轻医生工作量。有效的患者满意度测量方法必须校正患者特征的强烈影响。

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