Health Care Management, National Taipei University of Nursing and Health Sciences, Taipei, Taiwan.
Planning, National Health Insurance Admission, Taipei, Taiwan.
BMJ Open. 2019 Mar 8;9(3):e023045. doi: 10.1136/bmjopen-2018-023045.
Health system responsiveness is a complicated issue that guides researchers wishing to design an efficient methodology for enhancing understanding of perspectives regarding healthcare systems. This study examined the relationship between patient experience profiles and satisfaction with expectations of treatment effects.
This was a cross-sectional study. We used eight items obtained from latent class analysis to develop patient experience profiles.
Primary care users in Taiwan.
This study conducted an annual National Health Insurance survey in Taiwan and sampled from those who had experience with the medical service in primary care clinics in 2015.
Respondents were asked to indicate the extent of their satisfaction with their expectation of treatment effects (or symptom improvement).
The proportions of participants in groups 1-4 were 34%, 24%, 29% and 12%, respectively. Patients in good health were more satisfied with their expectations of treatment effects (OR 1.639, p=0.007). Furthermore, group 4 (-eAll) were less satisfied with their expectations of treatment effects than those in the other three groups (ORs: group 1 (+eAll): 9.81, group 2 (-CwR): 4.14 and group 3 (-CnR): 4.20).
The results revealed that experiences of poor accessibility and physician-patient relationships affected the patients' expectations. Therefore, greater accessibility and more positive physician-patient relationships could lead to higher patient satisfaction with their expectations of treatment effects. Furthermore, the findings could assist authorities in targeting specific patients, with the objective of improving their healthcare service experience. They could also serve as a mechanism for improving the quality of healthcare services and increase accountability in healthcare practices.
卫生系统反应性是一个复杂的问题，它指导着希望设计一种有效方法来增强对医疗保健系统观点理解的研究人员。本研究考察了患者体验特征与对治疗效果期望的满意度之间的关系。
这是一项横断面研究。我们使用潜在类别分析获得的 8 个项目来开发患者体验特征。
台湾的基层医疗使用者。
本研究在台湾进行了一项年度全民健康保险调查，并从 2015 年在基层诊所医疗服务中有过体验的人群中抽取样本。
受访者被要求表示他们对治疗效果期望（或症状改善）的满意度程度。
第 1-4 组的参与者比例分别为 34%、24%、29%和 12%。健康状况良好的患者对治疗效果的期望更满意（OR 1.639，p=0.007）。此外，与其他三组相比，第 4 组（-eAll）对治疗效果的期望更不满意（ORs：第 1 组（+eAll）：9.81，第 2 组（-CwR）：4.14，第 3 组（-CnR）：4.20）。
结果表明，可及性和医患关系体验不良会影响患者的期望。因此，增加可及性和更积极的医患关系可以提高患者对治疗效果期望的满意度。此外，这些发现可以帮助当局针对特定患者，以改善他们的医疗服务体验。它们还可以作为改善医疗服务质量和增加医疗实践问责制的机制。
