Department of Family Medicine, McGill University, Montréal, Canada.
Fam Pract. 2020 Sep 5;37(4):465-472. doi: 10.1093/fampra/cmaa011.
Patient satisfaction is an essential indicator in medical practise and research. To monitor the health and well-being of adult populations and the ageing process, the World Health Organization (WHO) has initiated the Study on Global AGEing and Adult Health (SAGE), compiling longitudinal information in six countries including China as one major data source.
The objective of this study was to identify potential predictors for patient satisfaction based on the 2007-10 WHO SAGE China survey.
Data were analysed using random forests (RFs) and ordinal logistic regression models based on 5774 responses to predict overall patient satisfaction on their most recent outpatient health services visit over the last 12 months. Potential predictor variables included access to care, costs of care, quality of care, socio-demographic and health care characteristics and health service features. Increase of the mean-squared error (incMSE) due to variable removal was used to assess relative importance of the model variables for accurately predicting patient satisfaction.
The survey data suggest low frequency of dissatisfaction with outpatient services in China (1.8%). Self-reported treatment outcome of the respective visit of a care facility demonstrated to be the strongest predictor for patient satisfaction (incMSE +15%), followed by patient-rated communication (incMSE +2.0%), and then income, waiting time, residency and patient age. Individual patient satisfaction in the survey population was predicted with 74% accuracy using either logistic regression or RF.
Patients' perceived outcomes of health care visits and patient communication with health care professionals are the most important variables associated with patient satisfaction in outpatient health services settings in China.
患者满意度是医学实践和研究的一个重要指标。为了监测成年人群体的健康和福祉以及老龄化进程，世界卫生组织（WHO）启动了全球老龄化与成人健康研究（SAGE），该研究将中国作为主要数据源之一，汇集了六个国家的纵向信息。
本研究旨在根据 2007-10 年世卫组织 SAGE 中国调查，确定患者满意度的潜在预测因素。
使用随机森林（RF）和有序逻辑回归模型对 5774 名受访者的数据进行分析，以预测过去 12 个月内最近一次门诊医疗服务就诊的总体患者满意度。潜在预测变量包括获得医疗服务的机会、医疗服务成本、医疗服务质量、社会人口学和健康状况以及医疗服务特征。由于变量移除而导致的均方误差增加（incMSE）用于评估模型变量对准确预测患者满意度的相对重要性。
调查数据表明，中国门诊服务的不满频率较低（1.8%）。就诊机构的自我报告治疗效果是预测患者满意度的最强预测因素（incMSE+15%），其次是患者对沟通的评价（incMSE+2.0%），然后是收入、等待时间、居住地点和患者年龄。使用逻辑回归或 RF 可分别以 74%的准确度预测调查人群中个体患者的满意度。
在门诊医疗服务环境中，患者对医疗保健就诊的感知结果和与医疗保健专业人员的沟通是与患者满意度最相关的最重要变量。
