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门诊手部外科办公室中的患者满意度:英语和西班牙语患者的比较。

Patient Satisfaction in an Outpatient Hand Surgery Office: A Comparison of English- and Spanish-Speaking Patients.

作者信息

Menendez Mariano E, Loeffler Markus, Ring David

机构信息

Orthopaedic Hand and Upper Extremity Service, Department of Orthopaedic Surgery, Massachusetts General Hospital, Boston.

出版信息

Qual Manag Health Care. 2015 Oct-Dec;24(4):183-9. doi: 10.1097/QMH.0000000000000074.

Abstract

BACKGROUND

As health care in the United States transitions from a fee-for-service to an outcomes-based environment, patient satisfaction is increasingly incentivized and publicly reported. Despite the continued growth of the Latino population and concomitant rise in the demand for health care, relatively little is known regarding patient satisfaction in Spanish speakers. We sought to compare patient satisfaction with hand surgery office visits between Spanish- and English-speaking patients.

METHODS

Directly after the office visit, 150 patients (75 English speakers and 75 Spanish speakers) completed a sociodemographic survey, an 11-point ordinal rating of pain intensity, and a survey of satisfaction with the encounter using items derived from the CG-CAHPS (Clinician and Group-Consumer Assessment of Healthcare Providers and Systems) survey. Multivariable regression modeling was used to identify factors associated with patient dissatisfaction.

RESULTS

Overall, 79% of Spanish-speaking patients were satisfied with the physician as compared with 91% of English speakers (P = .041). Compared with English-speaking patients, Spanish speakers were less likely to be satisfied with provider listening carefully (91% vs 100%, P = .007) and spending enough time with them (56% vs 93%, P < .001), as well as with waiting times (81% vs 96%, P = .005). There was no difference with regard to provider showing respect, clarity of communication, and explanation of what was done. Younger age and Spanish language were independent predictors of patient dissatisfaction.

CONCLUSIONS

Spanish-speaking patients are less satisfied with the care provided in a hand surgery office. In light of the growing diversity of the US population and the fact that patient satisfaction is increasingly tied to reimbursement, additional research might identify potential areas of improvement from both the surgeon (eg, communication strategies, cultural competence) and patient (eg health literacy, expectations) perspectives.

摘要

背景

随着美国医疗保健从按服务收费模式向基于结果的环境转变,患者满意度越来越受到激励并公开报告。尽管拉丁裔人口持续增长,对医疗保健的需求也随之增加,但对于讲西班牙语患者的满意度了解相对较少。我们试图比较讲西班牙语和讲英语的患者对手外科门诊就诊的满意度。

方法

门诊就诊结束后,150名患者(75名讲英语者和75名讲西班牙语者)完成了一项社会人口学调查、一项11分的疼痛强度序数评分,以及一项使用源自CG-CAHPS(医疗服务提供者和系统的临床医生与团体消费者评估)调查项目的就诊满意度调查。采用多变量回归模型来确定与患者不满意相关的因素。

结果

总体而言,79%的讲西班牙语患者对医生感到满意,而讲英语患者的这一比例为91%(P = 0.041)。与讲英语的患者相比,讲西班牙语的患者不太可能对提供者认真倾听(91%对100%,P = 0.007)、与他们共度足够时间(56%对93%,P < 0.001)以及等待时间(81%对96%,P = 0.005)感到满意。在提供者表示尊重、沟通清晰度以及对所做之事的解释方面没有差异。年龄较小和讲西班牙语是患者不满意的独立预测因素。

结论

讲西班牙语的患者对手外科门诊提供的护理不太满意。鉴于美国人口日益多样化,且患者满意度与报销越来越相关,更多研究可能会从外科医生(例如沟通策略、文化能力)和患者(例如健康素养、期望)的角度确定潜在的改进领域。

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