Singhealth Centre for Health Services Research, Singapore Health Services Pte Ltd, 226 Outram Road, Block A, #03-01, Singapore.
Singapore Med J. 2009 Oct;50(10):982-9.
In Singapore, few studies have been done on the factors that the general public considers to be most important in the healthcare system. We conducted this pilot study to determine the factor structure, reliability and validity of statements in a healthcare survey questionnaire as predictors of public perception of a good healthcare system.
Data on public perceptions of healthcare from a national survey of 1,434 adult Singaporeans was analysed using a principal component analysis and regression, to obtain the factors and predictors. The survey employed 31 statements on healthcare quality, cost, access and the role of the individual vis-à-vis society, which participants ranked on a five-point Likert scale.
The exploratory factor analysis identified six critical factors (F): National healthcare financing framework (F1), Service at public institutions (F2), Service at private institutions (F3), Individual responsibility for health (F4), Affordability at public institutions (F5), and Affordability at private institutions (F6). These factors explained 54 percent of variance, and Cronbach's alpha ranged from 0.5 to 0.72, except for F1. Regression analysis showed an association of public perception of good healthcare in Singapore with the following factors: F2 (odds ratio [OR] 1.79, 95 percent confidence interval [CI] 1.48-2.16, p-value is less than 0.0001); F3 (OR 1.29, 95 percent CI 1.10-1.52, p-value is less than 0.0001); F5 (OR 1.52, 95 percent CI 1.27-1.83, p-value is less than 0.0001); F1 (OR 1.31, 95 percent CI 1.08-1.59, p-value is 0.01); F4 (OR 1.33, 95 percent CI 1.16-1.54, p-value is less than 0.0001); but not with F6.
This pilot study provides a practical, reliable and valid first perception second level matrix to assess the Singapore healthcare system. Further snapshot surveys to assess perceptions of the healthcare system should be conducted with questionnaires abridged to include only these five identified critical factors.
在新加坡，针对公众认为医疗体系中最重要因素的研究甚少。本研究旨在初步探讨一份医疗保健调查问卷调查中各项陈述的结构因素、信度和效度，以确定其作为公众对优质医疗体系看法的预测因子。
对全国范围内 1434 名成年新加坡人的医疗保健认知进行调查，分析其数据，并采用主成分分析和回归分析来获取因素和预测因子。该调查采用 31 项关于医疗质量、成本、可及性以及个人与社会关系的陈述，参与者对这些陈述进行五点李克特量表评分。
探索性因子分析确定了 6 个关键因素（F）：国家医疗保健融资框架（F1）、公立机构服务（F2）、私立机构服务（F3）、个人健康责任（F4）、公立机构负担能力（F5）和私立机构负担能力（F6）。这 6 个因素解释了 54%的方差，Cronbach's alpha 介于 0.5 至 0.72 之间，除 F1 外。回归分析显示，新加坡公众对优质医疗保健的认知与以下因素有关：F2（比值比 [OR] 1.79，95%置信区间 [CI] 1.48-2.16，p 值小于 0.0001）；F3（OR 1.29，95%CI 1.10-1.52，p 值小于 0.0001）；F5（OR 1.52，95%CI 1.27-1.83，p 值小于 0.0001）；F1（OR 1.31，95%CI 1.08-1.59，p 值为 0.01）；F4（OR 1.33，95%CI 1.16-1.54，p 值小于 0.0001）；但与 F6 无关。
本研究提供了一个实用、可靠和有效的初步二级感知矩阵，用于评估新加坡的医疗体系。应进一步进行快照调查，使用简化后的问卷仅包括这五个确定的关键因素，以评估公众对医疗体系的看法。
