Department of Medicine.
Research Institute on Addictions, University at Buffalo, SUNY, Buffalo, NY.
J Clin Gastroenterol. 2018 Aug;52(7):614-621. doi: 10.1097/MCG.0000000000000906.
The goal of this study is to assess: (1) the relative contribution of patient factors to satisfaction ratings in irritable bowel syndrome (IBS) patients and (2) the relationship between patient satisfaction (PS) and the number of diagnostic tests patients underwent prior to receiving IBS diagnosis.
Although PS is regarded as an important indicator of quality of care, little is known about its determinants.
A total of 448 Rome III-diagnosed patients (M age=41 y; 79% F), whose GI symptoms were at least moderate in severity completed patient-reported outcome measures as part of pretreatment evaluation of an NIH-funded clinical trial. PS was measured with the 11-point Hospital Consumer Assessment of Healthcare Providers and Systems global rating scale modified to assess for IBS treatments. A series of multiple regression analyses were conducted for demographic, IBS-specific, general physical health, and psychological predictors before running a final model of significant predictors from each domain.
The final regression model was significant, F6,419=6.34, P<0.001, R=0.08, with race, insurance, number of diagnostic tests, and lower neuroticism predicting PS. Medical tests were rendered nonsignificant when history of seeking care from a gastroenterologist was introduced into the equation.
Contrary to hypotheses, neither the IBS symptom severity nor quality of life impairment predicted PS. Patient factors such as a neurotic personality style and sociodemographic profile had a significant but modest impact on PS. Pattern of regression analyses suggests that patients may turn to their gastroenterologist for testing for reassurance, which may in the long-term fuel demand for more testing.
本研究旨在评估:(1)患者因素对肠易激综合征(IBS)患者满意度评分的相对贡献;(2)患者满意度(PS)与患者接受 IBS 诊断前接受的诊断测试数量之间的关系。
尽管 PS 被认为是护理质量的重要指标,但对其决定因素知之甚少。
共有 448 名符合罗马 III 标准的患者(M 年龄=41 岁;79%为女性),其胃肠道症状至少为中度严重程度,作为 NIH 资助的临床试验的治疗前评估的一部分,他们完成了患者报告的结果测量。PS 通过 11 点医院消费者对医疗保健提供者和系统的全球评分量表进行测量,该量表经过修改,用于评估 IBS 治疗。在运行每个领域的重要预测因子的最终模型之前,对人口统计学、IBS 特异性、一般身体健康和心理预测因子进行了一系列多元回归分析。
最终回归模型具有统计学意义,F6,419=6.34,P<0.001,R=0.08,种族、保险、诊断测试数量和较低的神经质预测 PS。当将寻求胃肠病学家治疗的病史纳入方程时,医疗测试变得不显著。
与假设相反,IBS 症状严重程度或生活质量受损均不能预测 PS。患者因素,如神经质人格和社会人口统计学特征,对 PS 有显著但适度的影响。回归分析模式表明,患者可能会向他们的胃肠病学家寻求测试以获得保证,这可能会长期导致对更多测试的需求。