Otani Koichiro, Shen Ye, Chumbler Neale R, Judy Zachary, Herrmann Patrick A, Kurz Richard S
J Healthc Manag. 2015 May-Jun;60(3):205-18.
The purpose of this study was to investigate how patients' self-rated health status (SRHS) is associated with their attribute reaction integration process and, in turn, their overall ratings of hospitals. We collected patient satisfaction data from 70 hospitals by means of a patient satisfaction questionnaire. The sample included patients who were 18 years or older and discharged from the hospital from July 1, 2011, through June 30, 2012. Data for 36,528 patients were available for analysis. We conducted multiple linear regression analysis with patients' SRHS and interaction effects with nursing care, physician care, staff care, and room, while controlling for age, gender, race, and education. Study findings showed an association between SRHS levels and the patient's overall rating of the hospital; they also revealed interaction effects with nursing care, physician care, and staff care variables in the model. The statistically significant interaction effects indicate that for patients whose SRHS was less than excellent, physician care became more important and nursing care and staff care became less important compared with patients whose SRHS was excellent. When we consider the nature of medical care, this transition seems reasonable. We also found that it is reasonable to categorize patients into two groups: those whose SRHS is excellent and those whose SRHS is less than excellent (i.e., very good, good, fair, or poor). As the study findings show, these two groups of patients combined their attribute reactions differently.
本研究的目的是调查患者的自评健康状况(SRHS)如何与其属性反应整合过程相关联,进而与其对医院的总体评价相关联。我们通过患者满意度调查问卷从70家医院收集了患者满意度数据。样本包括年龄在18岁及以上、于2011年7月1日至2012年6月30日期间出院的患者。共有36,528名患者的数据可供分析。我们进行了多元线性回归分析,纳入了患者的SRHS以及与护理、医生护理、工作人员护理和病房的交互作用,同时控制了年龄、性别、种族和教育程度。研究结果显示了SRHS水平与患者对医院的总体评价之间的关联;还揭示了模型中与护理、医生护理和工作人员护理变量的交互作用。具有统计学意义的交互作用表明,与SRHS为优秀的患者相比,对于SRHS低于优秀水平的患者,医生护理变得更为重要,而护理和工作人员护理变得不那么重要。当我们考虑医疗护理的性质时,这种转变似乎是合理的。我们还发现,将患者分为两组是合理的:SRHS为优秀的患者和SRHS低于优秀水平的患者(即非常好、好、一般或差)。正如研究结果所示,这两组患者整合其属性反应的方式不同。