Li Xin, Zhang Haixia, Wang Jingwen, Li Fan, Chen Jing, Chen Jing
Int J Clin Pharmacol Ther. 2014 Jul;52(7):587-97. doi: 10.5414/CP202016.
There are few prior studies on patient satisfaction with medication related services and the potential value of measurements of patient satisfaction to the development of pharmaceutical care service (PCS) strategies in China. The objectives of the current study were to assess patient satisfaction with medication-related services in Chinese tertiary hospitals, examine the possible impact of PCS on patient satisfaction, and form a development strategy to establish PCS strategy prioritization.
Self administered questionnaires were distributed to 540 patients before discharge from units in 18 tertiary general hospitals in six cities. The participants assessed their satisfaction with the hospital's medication-related services based on a 7-point Likert-type scale. A comparative analysis between PCS and non-PCS pilot hospitals was conducted to evaluate the impact of PCS on patient satisfaction.
501 valid questionnaires were collected: 247 samples from PCS pilot hospitals (PCS group) and 254 from non-PCS pilot hospitals (non-PCS group). Factor analysis resulted in three factors (dimensions): "consideration and explanation", "discharge instruction", and "efficacy and finance". The "efficacy and finance" scores indicated relative satisfaction with this dimension (mean = 5.63 ± 1.36). However, the items "medication costs" and "other medical costs" were the lowest scored attributes (means = 4.98 ± 1.62 and 4.95 ± 1.63), indicating that most of the participants were dissatisfied with these financial attributes. The median score in the "consideration and explanation" dimension in the PCS group was 6.27, in comparison with 5.81 in the non-PCS group. This statistically significant difference (p < 0.01) demonstrates that the major impact of PCS on patient satisfaction is observed in the "consideration and explanation" dimension.
This study revealed low patient satisfaction with the financial aspects of medication-related services, which must be improved to provide better inpatient hospital service. The clinical effectiveness of medication therapy at these 18 tertiary hospitals could meet patients' expectations, but PCS did not increase the level of patient satisfaction in the "efficacy and finance" dimension. Future PCS strategy in China should focus on improving the clinical and economic outcomes of medication-related services.
此前关于中国患者对药物相关服务的满意度以及患者满意度测量对药学服务（PCS）策略发展的潜在价值的研究较少。本研究的目的是评估中国三级医院患者对药物相关服务的满意度，考察PCS对患者满意度的可能影响，并形成制定PCS策略优先级的发展策略。
在六个城市的18家三级综合医院的科室中，在患者出院前向540名患者发放自填式问卷。参与者根据7点李克特量表评估他们对医院药物相关服务的满意度。对PCS试点医院和非PCS试点医院进行比较分析，以评估PCS对患者满意度影响。
共收集到501份有效问卷：247份来自PCS试点医院（PCS组），254份来自非PCS试点医院（非PCS组）。因子分析得出三个因子（维度）：“关怀与解释”、“出院指导”和“疗效与费用”。“疗效与费用”得分表明对该维度相对满意（均值=5.63±1.36）。然而，“药费”和“其他医疗费用”项目得分最低（均值分别为4.98±1.62和4.95±1.63），表明大多数参与者对这些费用项目不满意。PCS组“关怀与解释”维度的中位数得分是6.27，而非PCS组为5.81。这一具有统计学意义的差异（p<0.01）表明，PCS对患者满意度的主要影响体现在“关怀与解释”维度。
本研究显示患者对药物相关服务的费用方面满意度较低，必须加以改善以提供更好的住院服务。这18家三级医院药物治疗的临床疗效能够满足患者期望，但PCS在“疗效与费用”维度并未提高患者满意度水平。中国未来的PCS策略应侧重于改善药物相关服务的临床和经济结果。
