Williams S J, Calnan M
Centre for Health Services Studies (CHSS), University of Kent, Canterbury, U.K.
Soc Sci Med. 1991;33(6):707-16. doi: 10.1016/0277-9536(91)90025-8.
This paper describes the results of the first-stage of a study carried out in the spring of 1988 in the South East of England. The study looked at general and specific aspects of consumer satisfaction with general practitioner services, general dental care services and hospital in-patients care. It also examined which specific consumer criteria were the key predictors of overall satisfaction within each of these particular medical care settings. A related aim was to assess the degree of congruence or divergence of consumer criteria across these differing medical care settings. The evidence suggests that whilst general levels of consumer satisfaction are high (i.e. 83-97%), questions of a more detailed and specific nature revealed greater levels of expressed dissatisfaction (e.g. 38% of the sample felt that they could not discuss personal problems with their GP, 51% felt their dentist was not easy to reach at weekends/holidays, whilst 35% felt hospital doctors did not give sufficient information). Whilst different areas of dissatisfaction were found in each specific medical care setting examined, what was particularly striking was the degree of convergence of the key predictors of overall consumer satisfaction across the medical care settings. That is to say, our findings clearly suggest that issues concerning 'professional competence', together with the nature and quality of the patient-professional relationship, are the key predictors of overall consumer satisfaction with general practice, dental and hospital care [e.g. GP giving sufficient information correlated 0.64 (P less than 0.001) with overall GP satisfaction scores; competent dentist 0.52 (P less than 0.001) with overall dental satisfaction scores; and full confidence in hospital doctors 0.49 (P less than 0.001) with overall hospital satisfaction scores]. The theoretical importance and policy implications of these findings, particularly in the light of the recent NHS reforms, are discussed.
本文描述了1988年春季在英格兰东南部开展的一项研究第一阶段的结果。该研究着眼于消费者对全科医生服务、普通牙科护理服务和医院住院护理的总体及具体满意度。它还考察了在这些特定医疗护理环境中，哪些具体的消费者标准是总体满意度的关键预测因素。一个相关目标是评估这些不同医疗护理环境中消费者标准的一致程度或差异程度。证据表明，虽然消费者总体满意度较高（即83%-97%），但更详细和具体的问题显示出更高程度的不满（例如，38%的样本觉得他们无法与全科医生讨论个人问题，51%觉得他们的牙医在周末/节假日不容易联系上，而35%觉得医院医生提供的信息不足）。虽然在所考察的每个特定医疗护理环境中都发现了不同的不满领域，但特别引人注目的是跨医疗护理环境的总体消费者满意度关键预测因素的趋同程度。也就是说，我们的研究结果清楚地表明，与专业能力相关的问题以及患者与专业人员关系的性质和质量，是消费者对全科医疗、牙科和医院护理总体满意度的关键预测因素[例如，全科医生提供足够信息与全科医生总体满意度得分的相关性为0.64（P小于0.001）；称职的牙医与牙科总体满意度得分的相关性为0.52（P小于0.001）；对医院医生的充分信心与医院总体满意度得分的相关性为0.49（P小于0.001）]。本文讨论了这些发现的理论重要性和政策含义，特别是鉴于近期英国国家医疗服务体系（NHS）的改革。
