Schaal Tom, Schoenfelder Tonio, Klewer Joerg, Kugler Joachim
Department of Public Health, Dresden Medical School, University of Dresden, Loescherstrasse 18, Dresden, Saxony, Germany.
Department of Public Health and Health Care Management, University of Applied Sciences Zwickau, Dr.-Friedrichs-Ring 2A, Zwickau, Saxony, Germany.
PLoS One. 2017 Jun 13;12(6):e0178591. doi: 10.1371/journal.pone.0178591. eCollection 2017.
The increase in the number of patients presenting with osteoarthritis in the past decade has led to a 32% increase in knee replacement surgeries designed to reduce restrictions on patient movement and improve their quality of life. Patient satisfaction is becoming an increasingly important indicator of quality of care. This study was designed to identify predictors of various service components in the treatment process and hospital key performance indicators significantly associated with patient satisfaction.
A multicenter cross-sectional study was conducted with 856 patients having their primary total knee replacements at 41 hospitals. Patient satisfaction was queried via a validated, multidimensional questionnaire mainly using a six-point scale. In addition to bivariate calculations, patient satisfaction was the dependent variable in a binary logistic regression model.
The bivariate analysis showed a strong association between satisfaction and sex (male or female), the patients' health before admission, and the length of stay. The number of cases treated at each hospital did not reveal any impact on satisfaction. The multivariate analysis identified three predictors associated with overall satisfaction. The strongest factor was the treatment outcome and the weakest was the quality of food. It became apparent that the statutory procedure minimums were not being met.
The relevant factors influencing patient satisfaction were partially the same as previous study results and allowed more detailed conclusions. The results provide suggestions across hospitals that could help health care providers better meet needs of patients after knee arthroplasties.
在过去十年中，骨关节炎患者数量的增加导致旨在减少患者行动限制并提高其生活质量的膝关节置换手术增加了32%。患者满意度正日益成为医疗质量的重要指标。本研究旨在确定治疗过程中各种服务要素的预测因素以及与患者满意度显著相关的医院关键绩效指标。
对41家医院的856例行初次全膝关节置换术的患者进行了一项多中心横断面研究。通过一份经过验证的多维问卷主要采用六点量表对患者满意度进行询问。除双变量计算外，患者满意度是二元逻辑回归模型中的因变量。
双变量分析显示满意度与性别（男性或女性）、入院前患者健康状况以及住院时间之间存在密切关联。每家医院治疗的病例数对满意度没有显示出任何影响。多变量分析确定了与总体满意度相关的三个预测因素。最强的因素是治疗结果，最弱的是食物质量。很明显，法定程序最低标准未得到满足。
影响患者满意度的相关因素部分与先前的研究结果相同，并得出了更详细的结论。研究结果为各医院提供了建议，有助于医疗服务提供者在膝关节置换术后更好地满足患者需求。
