Department for Quality Measurement and Patient Safety, Norwegian Knowledge Centre for the Health Services, Boks 7004 St Olavs plass, 0130 Oslo, Norway.
BMJ Qual Saf. 2012 Jan;21(1):39-46. doi: 10.1136/bmjqs-2011-000137. Epub 2011 Aug 26.
Patient satisfaction and experiences are important parts of healthcare quality, but patient expectations are seldom included in quality assessments. The objective of this study was to estimate the effects of different predictors of overall patient satisfaction with hospitals, including patient-reported experiences, fulfilment of patient expectations and socio-demographic variables.
Data were collected using a national patient-experience survey of 63 hospitals in the five health regions in Norway during the autumn of 2006. Postal questionnaires were mailed to 24 141 patients after their discharge from hospital. Non-respondents were sent a reminder after 4 weeks. Multivariate linear regression analysis including multilevel regression was used to assess the predictors of overall patient satisfaction with hospitals.
Thirteen variables were significantly associated with overall patient satisfaction: two variables about fulfilment of expectations, eight about patient-reported experiences and three socio-demographic variables. The regression model explained 59% of the variation in overall patient satisfaction. The most important predictor of patient satisfaction with hospitals was patient-reported experiences with the nursing services (β=0.27, p<0.001), followed by fulfilment of patient expectations (β=0.21, p<0.001), experiences with doctor services (β=0.12, p<0.001) and perceived incorrect treatment (β=-0.12, p<0.001). Multilevel regression analysis confirmed most of the findings, but revealed that age was not a significant predictor of overall patient satisfaction.
The study showed that both fulfilment of expectations and patient-reported experiences are distinct from but related to overall patient satisfaction. The most important predictors for overall patient satisfaction with hospitals are patient-reported experiences and fulfilment of expectations.
患者满意度和体验是医疗质量的重要组成部分，但患者期望很少被纳入质量评估中。本研究旨在评估不同因素对患者整体满意度的影响，这些因素包括患者报告的体验、满足患者期望以及社会人口统计学变量。
使用挪威五个卫生区域的 63 家医院在 2006 年秋季开展的全国患者体验调查收集数据。在患者出院后，向 24141 名患者邮寄了问卷调查表。对未回复者在 4 周后寄出提醒信。采用多元线性回归分析（包括多层次回归）评估整体患者满意度的预测因素。
有 13 个变量与患者对医院的整体满意度显著相关：2 个与期望满足相关的变量，8 个与患者报告的体验相关的变量，以及 3 个社会人口统计学变量。回归模型解释了患者对医院整体满意度变化的 59%。预测患者对医院满意度最重要的因素是患者对护理服务的报告体验（β=0.27，p<0.001），其次是患者期望的满足程度（β=0.21，p<0.001）、患者对医生服务的体验（β=0.12，p<0.001）和感知治疗不当（β=-0.12，p<0.001）。多层次回归分析证实了大部分发现，但显示年龄不是整体患者满意度的显著预测因素。
本研究表明，期望的满足和患者报告的体验与整体患者满意度不同但相关。预测患者对医院整体满意度的最重要因素是患者报告的体验和期望的满足。
