South East Wales Trials Unit, Department of Primary Care and Public Health, School of Medicine, Cardiff University, Second Floor, Neuadd Meirionnydd, Heath Park, Cardiff CF14 4YS.
Fam Pract. 2010 Dec;27(6):652-63. doi: 10.1093/fampra/cmq057. Epub 2010 Jul 29.
several different models of out-of-hours primary care now exist in the UK. Important outcomes of care include users' satisfaction and enablement to manage their illness or condition, but the determinants of these outcomes in the unscheduled care domain are poorly understood. Aim. To identify predictors of user satisfaction and enablement across unscheduled care or GP out-of-hours service providers in Wales. The design of the study is a cross-sectional survey. The setting of the study is nine GP out-of-hours services, three Accident and Emergency units and an all Wales telephone advice service in Wales.
postal survey using the Out-of-hours Patient Questionnaire. Logistic regression was used to fit both satisfaction and enablement models, based on demographic variables, service provider and treatment received and perceptions or ratings of the care process.
eight hundred and fifty-five of 3250 users responded (26% response rate, range across providers 14-41%, no evidence of non-response bias for age or gender). Treatment centre consultations were significantly associated with decreased patient satisfaction and decreased enablement compared with telephone advice. Delays in call answering or callback for triage and shorter consultations were significantly associated with lower satisfaction. Waiting more than a minute for initial call answering was associated with lower enablement.
giving users more time to discuss their illness in consultations may enhance satisfaction and enablement but this may be resource intensive. More simple interventions to improve access by quicker response and triage, and keeping users informed of waiting times, could also serve to increase satisfaction and ultimately impact on their enablement.
英国目前存在几种不同模式的非工作时间初级保健。护理的重要结果包括用户的满意度和管理其疾病或病情的能力，但非计划性护理领域这些结果的决定因素尚未得到很好的理解。目的：确定威尔士非工作时间医疗保健或全科医生夜间服务提供者之间用户满意度和赋能的预测因素。该研究的设计是一项横断面调查。研究地点是威尔士的 9 个全科医生夜间服务、3 个急症室和一个全威尔士电话咨询服务。
使用夜间病人调查问卷进行邮寄调查。基于人口统计学变量、服务提供者和接受的治疗以及对护理过程的看法或评价，使用逻辑回归来拟合满意度和赋能模型。
3250 名用户中有 855 名（26%的回应率，各提供者的回应率范围为 14-41%，年龄和性别无回应偏差的证据）做出了回应。与电话咨询相比，治疗中心就诊与患者满意度降低和赋能降低显著相关。呼叫接听或分诊回叫延迟以及就诊时间缩短与满意度降低显著相关。初始呼叫接听等待超过 1 分钟与赋能降低显著相关。
在就诊中给予用户更多时间讨论他们的病情可能会提高满意度和赋能，但这可能需要更多的资源。更简单的干预措施可以通过更快的响应和分诊来改善获取途径，并让用户了解等待时间，这也可以提高满意度，并最终影响他们的赋能。
