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员工型健康维护组织中的会员满意度。

Member satisfaction in a staff-model health maintenance organization.

作者信息

Hiramatsu S

机构信息

Group Health Cooperative of Puget Sound, Seattle, WA 98121.

出版信息

Am J Hosp Pharm. 1990 Oct;47(10):2270-3.

PMID:2248268
Abstract

The results of a June 1988 member-satisfaction survey undertaken by a staff-model health maintenance organization (HMO) are presented, and implications for HMO management are discussed. Focus groups identified key reasons for consumer satisfaction; results were incorporated into a telephone survey that was administered to 600 households randomly selected from among enrollees and to an equal number of nonenrollees in the same region. Questions covered five areas: (1) importance-of-health-plan issues, (2) predictors of health-plan satisfaction, (3) importance-of-provider issues, (4) predictors of satisfaction with providers, and (5) demographics and use of services. Comprehensiveness of coverage was the most important factor in selection of a health plan; cost ranked second. Factors related to health-plan satisfaction included quality and quantity of plan physicians, access to specialists, and scope of benefits. Analysis of the dependent variable, perceived quality of physician care, revealed that physician technical skills, physician availability after hours, and equipment and facilities were among the highest-ranking factors. Enrollees were significantly more satisfied with their health plan overall than were members of preferred-provider organizations or indemnity health plans. Management concluded that member satisfaction was related to the number of physicians available and the ease of access to a preferred physician. Physician quality appeared to be the prime determinant of member satisfaction. Competition will spur health plans to place more interest on identifying and responding to member preferences.

摘要

本文呈现了1988年6月一家员工型健康维护组织(HMO)开展的会员满意度调查结果,并讨论了其对HMO管理的启示。焦点小组确定了消费者满意度的关键原因;调查结果被纳入一项电话调查,该调查针对从参保者中随机抽取的600户家庭以及同一地区数量相等的非参保者进行。问题涵盖五个领域:(1)健康计划问题的重要性,(2)健康计划满意度的预测因素,(3)医疗服务提供者问题的重要性,(4)对医疗服务提供者满意度的预测因素,以及(5)人口统计学和服务使用情况。保险范围的全面性是选择健康计划时最重要的因素;成本排名第二。与健康计划满意度相关的因素包括计划医生的质量和数量、获得专科医生的机会以及福利范围。对因变量“医生护理的感知质量”的分析表明,医生的技术技能、下班后医生的可及性以及设备和设施是排名最高的因素之一。总体而言,参保者对其健康计划的满意度明显高于优先提供者组织或赔偿型健康计划的成员。管理层得出结论,会员满意度与可用医生的数量以及获得首选医生的难易程度有关。医生质量似乎是会员满意度的主要决定因素。竞争将促使健康计划更加关注识别和回应会员偏好。

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