Boss Emily F, Thompson Richard E
Department of Otolaryngology - Head and Neck Surgery, Johns Hopkins University School of Medicine, United States.
Int J Pediatr Otorhinolaryngol. 2013 Jan;77(1):59-64. doi: 10.1016/j.ijporl.2012.09.030. Epub 2012 Oct 23.
Patient experience scores are now recognized as a chief indicator of healthcare quality. This report compares outpatient pediatric otolaryngology patient satisfaction in the teaching and non-teaching settings.
Cross-sectional, multi-site, patient-level analysis of satisfaction surveys (Press Ganey™ Medical Practice©) completed by parents of pediatric otolaryngology patients in FY2010.
Surveys were stratified by teaching/non-teaching affiliation. The survey has 29 Likert-scaled questions which comprise an overall score and subscores in 6 domains: access, visit, nursing, provider, personal issues, and assessment. The item likelihood-to-recommend was measured to indicate practice loyalty. Mean scores were compared by Kruskal-Wallis rank test. Multivariate logistic regression was performed to evaluate the association of teaching status with receipt of highest scores (HI-SCORES).
4704 pediatric surveys were analyzed, with 1984 (42%) from the teaching setting. For the teaching setting, mean scores were lower overall (88.1 vs. 89.0; p<0.001) and in domains of access (includes scheduling ease, promptness in returning calls; 86.7 vs. 89.4; p<0.001) and personal issues (includes office hour convenience, sensitivity to needs; 87.0 vs. 88.5; p<0.001). Differences in access scores were largest for young children (0-<6 years; 86.0 vs. 89.5; p<0.001). Children in the teaching setting were less likely to have HI-SCORES overall (OR 0.78; 95%CI 0.65-0.95; p=0.011) and for access (OR 0.8; 95%CI 0.67-0.95; p=0.012); probability of HI-SCORES was similar for the two settings for all other domains.
Parents of pediatric otolaryngology patients evaluated in the teaching setting report lower satisfaction related to access, but similar scores for care providers and practice loyalty. Academic otolaryngology practices might focus on access issues to improve the overall care experience for children and families.
患者体验评分如今被视为医疗质量的主要指标。本报告比较了教学机构和非教学机构中儿科耳鼻喉科门诊患者的满意度。
对2010财年儿科耳鼻喉科患者家长完成的满意度调查(Press Ganey™医疗实践©)进行横断面、多地点、患者层面的分析。
调查按教学/非教学隶属关系分层。该调查有29个李克特量表问题,包括一个总体得分和6个领域的子得分:就诊便利性、就诊体验、护理、医疗服务提供者、个人问题和评估。通过测量“推荐可能性”项目来表明对医疗实践的忠诚度。采用Kruskal-Wallis秩和检验比较平均得分。进行多因素逻辑回归以评估教学状态与获得高分(HI-SCORES)之间的关联。
分析了4704份儿科调查问卷,其中1984份(42%)来自教学机构。在教学机构中,总体平均得分较低(88.1对89.0;p<0.001),在就诊便利性领域(包括预约容易程度、回电及时性;86.7对89.4;p<0.001)和个人问题领域(包括办公时间便利性、对需求的敏感度;87.0对88.5;p<0.001)也是如此。就诊便利性得分差异在幼儿(0至<6岁;86.0对89.5;p<0.001)中最为明显。教学机构中的儿童总体上获得高分的可能性较小(OR 0.78;95%CI 0.65 - 0.95;p = 0.011),在就诊便利性方面也是如此(OR 0.8;95%CI 0.67 - 0.95;p = 0.012);在所有其他领域,两个机构获得高分的概率相似。
在教学机构接受评估的儿科耳鼻喉科患者家长报告在就诊便利性方面满意度较低,但在医疗服务提供者和对医疗实践的忠诚度方面得分相似。学术性耳鼻喉科医疗实践可能应关注就诊便利性问题,以改善儿童及其家庭的整体就医体验。