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门诊儿科耳鼻喉科的患者体验。

Patient experience in outpatient pediatric otolaryngology.

机构信息

Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.

出版信息

Laryngoscope. 2012 Oct;122(10):2304-10. doi: 10.1002/lary.23364. Epub 2012 May 30.

Abstract

OBJECTIVES/HYPOTHESIS: Patient experience scores are emerging as a key measure of healthcare quality. This report evaluated differences in outpatient otolaryngology patient satisfaction scores by age.

STUDY DESIGN

Patient-level analysis of Press Ganey Medical Practice surveys completed by otolaryngology patients or parents in 2010.

METHODS

Surveys were grouped by child (<18 years old) or adult age. Children were evaluated in three subgroups (0-5 years, 6-12 years, and 13-17 years). The survey contains 29 items, which comprise six service domains of access, visit, nursing, provider, personal issues, and assessment. Comparison of mean scores was performed using the Kruskal-Wallis rank test for nonparametric data. Multivariate logistic regression analysis was performed to evaluate association of age with receipt of highest scores (HI-SCORES) in each domain.

RESULTS

Of 44,010 surveys analyzed, 5,996 (13.6%) were pediatric. The majority of children were <6 years (n = 3,141; 52.4%). Mean scores were lower for children overall (88.4 children vs. 90.2 adults) and in domains of access, visit, nursing, issues, and assessment (P < .005, all comparisons); scores were equal for care provider. Mean scores were lowest for children 0 to 5 years across all domains (overall means: 88.0, 0-5; 88.4, 6-12; 89.4, 13-17; 90.2 >18; P = .0001) and increased with age. Multivariate analysis showed that children were less likely than adults to give HI-SCORES overall (odds ratio, 0.81, 95% confidence interval, 0.76-0.86; P < .001) and in all domains (P = .0001) except for provider.

CONCLUSIONS

Compared to adults, satisfaction is lower in all service domains except care provider for pediatric otolaryngology patients, and is lowest for younger children. Otolaryngologists should consider the unique needs of the child and family to improve overall patient experience.

摘要

目的/假设:患者体验评分作为医疗质量的关键衡量标准之一正在逐渐兴起。本报告评估了不同年龄段门诊耳鼻喉科患者满意度评分的差异。

研究设计

对 2010 年接受耳鼻喉科患者或其家长填写的 Press Ganey 医疗实践调查的患者水平进行分析。

方法

根据患者年龄(儿童<18 岁和成人)将调查进行分组。儿童根据年龄(0-5 岁、6-12 岁和 13-17 岁)分为三个亚组。该调查包含 29 个项目,分为六个服务领域:就诊预约、就诊过程、护理、医护人员、个人问题和评估。采用非参数数据 Kruskal-Wallis 秩检验比较平均评分。采用多变量逻辑回归分析评估各领域中年龄与获得最高分(HI-SCORES)的关系。

结果

在分析的 44010 份调查中,有 5996 份(13.6%)为儿科患者。大多数儿童<6 岁(n=3141;52.4%)。总体而言,儿童的评分较低(儿童 88.4 分 vs. 成人 90.2 分),且在就诊预约、就诊过程、护理、个人问题和评估领域的评分较低(P<0.005,所有比较);在医护人员方面的评分相同。所有领域中,0-5 岁儿童的评分最低(总体平均值:88.0,0-5 岁;88.4,6-12 岁;89.4,13-17 岁;90.2>18 岁;P=0.0001),且随年龄增长而增加。多变量分析显示,与成人相比,儿童在所有领域的总体 HI-SCORES 评分较低(优势比,0.81,95%置信区间,0.76-0.86;P<0.001),且在所有领域(P=0.0001)除医护人员领域外均较低。

结论

与成人相比,儿科耳鼻喉科患者除医护人员外,在所有服务领域的满意度均较低,且年龄越小的儿童满意度越低。耳鼻喉科医生应考虑儿童及其家庭的特殊需求,以提高整体患者体验。

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