Tak Hyojung, Ruhnke Gregory W, Shih Ya-Chen Tina
Department of Health Management and Policy, University of North Texas Health Science Center, 3500 Camp Bowie Boulevard, Fort Worth, TX, 76107, USA,
Patient. 2015 Apr;8(2):187-97. doi: 10.1007/s40271-014-0073-0.
Little is known about the attributes of care that most strongly impact satisfaction in real-world settings where patients' limited medical knowledge may restrict their ability to ascertain the true quality of care. We therefore examined the association between patient-centered attributes of physician care (thoroughness, explanation, and listening), in-office waiting time, and patient satisfaction.
We used the Community Tracking Study Household Survey, a US nationally representative dataset (n = 71,594). Using logistic regression models, we analyzed the association between patient ratings of care attributes and patient satisfaction for the total sample and by subgroups, according to health status, physician type, and visit type.
Patients' perception of excellent or very good care attributes was strongly associated with being very satisfied with care received (thoroughness of care, odds ratio [OR] 2.64, 95 % confidence interval [CI] 2.31-3.02; listening, OR 2.04, 95 % CI 1.77-2.36; explanation, OR 1.63, 95 % CI 1.42-1.86), as was a waiting time of ≤10 min (OR 1.50, 95 % CI 1.39-1.63). The effect magnitude of thoroughness on satisfaction is particularly strong relative to high-quality listening and explanation among respondents in poor health, and for whom the most recent office visit was to see a generalist or for curative care.
Thoroughness of care was the strongest determinant of patient satisfaction, followed by physician listening and explanation. Especially with patients' improved access to current medical information, it is important for physicians to recognize that excellent communication cannot serve as a substitute for high-quality, thorough care.
在现实环境中，患者医学知识有限可能会限制其判断医疗服务真正质量的能力，对于最能影响满意度的医疗服务属性，人们了解甚少。因此，我们研究了以患者为中心的医生医疗服务属性（全面性、解释和倾听）、候诊时间与患者满意度之间的关联。
我们使用了社区追踪研究家庭调查，这是一个具有美国全国代表性的数据集（n = 71,594）。我们使用逻辑回归模型，分析了总体样本以及按健康状况、医生类型和就诊类型划分的亚组中，患者对医疗服务属性的评分与患者满意度之间的关联。
患者对优质或非常好的医疗服务属性的感知与对所接受医疗服务非常满意密切相关（医疗服务的全面性，优势比[OR] 2.64，95%置信区间[CI] 2.31 - 3.02；倾听，OR 2.04，95% CI 1.77 - 2.36；解释，OR 1.63，95% CI 1.42 - 1.86），候诊时间≤10分钟时也是如此（OR 1.50，95% CI 1.39 - 1.63）。在健康状况较差的受访者中，以及最近一次门诊是看全科医生或进行治疗性医疗服务的受访者中，相对于高质量的倾听和解释，全面性对满意度的影响程度尤为强烈。
医疗服务的全面性是患者满意度的最强决定因素，其次是医生的倾听和解释。特别是随着患者获取当前医学信息的机会增加，医生必须认识到，良好的沟通不能替代高质量、全面周到的医疗服务。
