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[社会经济和健康背景在患者满意度中的相关性]

[Relevance of the socioeconomic and health context in patient satisfaction].

作者信息

Pérez-Romero Shirley, Gascón-Cánovas Juan J, Salmerón-Martínez Diego, Parra-Hidalgo Pedro, Monteagudo-Piqueras Olga

机构信息

Área de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Murcia, Murcia, España.

Área de Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Murcia, Murcia, España.

出版信息

Gac Sanit. 2017 Sep-Oct;31(5):416-422. doi: 10.1016/j.gaceta.2017.05.003. Epub 2017 Jul 11.

Abstract

OBJECTIVE

To determine which factors of the socioeconomic and health contexts influence the perception of the satisfaction of the population with the health services.

METHODS

The data come from the European Health Survey of 2009. In the 22,188 subjects surveyed, the relationship between the perception of satisfaction with the health services received and the individual and contextual variables was studied, applying a multilevel analysis.

RESULTS

The factors of the socioeconomic and health contexts that influence satisfaction are: higher rates of low level of studies where the perception of excellence is less likely (odds ratio [OR]: 0.48-0.82) and dissatisfaction is more prevalent (OR: 1.46-1.63). Likewise, the proportion of unsatisfied citizens is lower when per capita expenditure on health services is very high (>1400 €) (OR: 0.49-0.87) and the ratio "primary health care physicians/inhabitants" is high (>60) (OR: 0.500.85). In addition, the prevalence of dissatisfaction describes a positive linear trend with the unemployment rate (OR: 1.12; p=0.0001) and the relative magnitude of the services sector (OR: 1.03; p=0.001). By contrast, this linear trend is negative as the Health Care Coverage Ratio increases (OR: 0.88; p=0.04).

CONCLUSIONS

The individual factors that determine patient satisfaction are: sex, age, mental health and country of birth. In addition, there are differences in patient satisfaction among the autonomous communities according to socio-economic determinants such as GDP per capita, low-level study rates, unemployment rates or number of inhabitants/doctor's ratio. User satisfaction studies as well as being adjusted for individual variables such as sex, age or health level should also take into account characteristics of the socioeconomic environment of the geographic area where they reside.

摘要

目的

确定社会经济和健康背景中的哪些因素会影响民众对医疗服务满意度的认知。

方法

数据来自2009年欧洲健康调查。在22188名被调查对象中,运用多层次分析研究了对所接受医疗服务的满意度认知与个体及背景变量之间的关系。

结果

影响满意度的社会经济和健康背景因素包括:低学历比例较高的地区,民众对医疗服务卓越性的认知可能性较低(优势比[OR]:0.48 - 0.82),不满情绪更为普遍(OR:1.46 - 1.63)。同样,当医疗服务人均支出非常高(>1400欧元)时,不满意公民的比例较低(OR:0.49 - 0.87),且“初级保健医生/居民”比例较高(>60)时也是如此(OR:0.50 - 0.85)。此外,不满情绪的患病率与失业率呈正线性趋势(OR:1.12;p = 0.0001)以及服务业相对规模呈正线性趋势(OR:1.03;p = 0.001)。相比之下,随着医疗保健覆盖率的增加,这种线性趋势为负(OR:0.88;p = 0.04)。

结论

决定患者满意度的个体因素包括:性别、年龄、心理健康状况和出生国家。此外,根据社会经济决定因素,如人均国内生产总值、低学历率、失业率或居民/医生比例,各自治区患者满意度存在差异。用户满意度研究除了针对性别、年龄或健康水平等个体变量进行调整外,还应考虑他们居住地理区域的社会经济环境特征。

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