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测量越南心血管疾病患者对医疗服务的满意度。

Measuring satisfaction with health care services for Vietnamese patients with cardiovascular diseases.

机构信息

Division of Social Welfare and Health Administration, Wonkwang University, Iksan, Korea.

Center of Excellence in Evidence-based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam.

出版信息

PLoS One. 2020 Jun 25;15(6):e0235333. doi: 10.1371/journal.pone.0235333. eCollection 2020.

Abstract

Patient satisfaction is a useful predictor of adherence and outcomes of cardiovascular diseases (CVDs) treatment. This study explored the satisfaction of Vietnamese CVDs inpatients and outpatients using a scale specifically designed for CVDs patients and examined the factors associated with satisfaction towards CVDs treatment services. Interviews of 600 patients at the Hanoi Heart Hospital were conducted. We developed a measurement scale for both inpatient and outpatient services. Multivariate Tobit regression was used to determine the associated factors with patient satisfaction. For inpatients, Cronbach's alpha reported for the domains were in the range of 0.72-0.97, while for outpatients, Cronbach's alpha was within 0.61-0.97. Overall, patients were more satisfied with inpatient services (Mean = 81.8, SD = 5.8) than outpatient services (Mean = 79.7, SD = 5.2, p<0.05). In inpatients, the highest complete satisfaction was in "Attitude of Nurse" item (42.0%), the highest satisfaction score was in "Care and treatment" domain (Mean = 85.6, SD = 9.7) and the lowest in "Hospital facilities" domain (Mean = 78.3; SD = 9.2). Among outpatients, the highest complete satisfaction was in "Attitude of physicians when examining, guiding and explaining to the patient" item (19.7%), the highest satisfaction score was in "Attitude of medical staff" domain (Mean = 82.8; SD = 7.9) and the lowest in "Waiting time" domain (Mean = 76.6; SD = 8.2). People not having health insurances had significantly higher scores in "Waiting time", "Hospital facilities" and "Attitude of staff" domains (for outpatients) and in "Health service accessibility", "Hospital facilities" domains (for inpatients) as well as higher total satisfaction score than those having health insurance. Findings discovered through the application of the newly developed instrument showed low satisfaction regarding hospital facilities for inpatients and waiting time for outpatients, suggesting renovation efforts, while inferiority regarding patient satisfaction of health insurance covered patients compared to those without implied policy reform possibility. Further enhancement and validation of the developed instrument was required.

摘要

患者满意度是评估心血管疾病(CVDs)治疗依从性和效果的有用指标。本研究采用 CVDs 患者专用量表,调查了越南 CVDs 住院和门诊患者的满意度,并分析了影响患者对 CVDs 治疗服务满意度的相关因素。对河内心脏医院的 600 名患者进行了访谈。我们为住院和门诊服务分别开发了测量量表。采用多元 Tobit 回归分析确定与患者满意度相关的因素。对于住院患者,各领域的 Cronbach's alpha 系数在 0.72-0.97 之间,而对于门诊患者,Cronbach's alpha 系数在 0.61-0.97 之间。总体而言,患者对住院服务(均值=81.8,SD=5.8)的满意度高于门诊服务(均值=79.7,SD=5.2,p<0.05)。在住院患者中,对护士态度的完全满意度最高(42.0%),对护理和治疗的满意度最高(均值=85.6,SD=9.7),对医院设施的满意度最低(均值=78.3;SD=9.2)。在门诊患者中,对医生在检查、指导和向患者解释时的态度完全满意的比例最高(19.7%),对医务人员态度的满意度最高(均值=82.8;SD=7.9),对等待时间的满意度最低(均值=76.6;SD=8.2)。未参加健康保险的患者在“等待时间”、“医院设施”和“工作人员态度”(门诊患者)以及“卫生服务可及性”、“医院设施”(住院患者)等领域的得分显著高于参加健康保险的患者,总满意度得分也高于参加健康保险的患者。应用新开发工具发现的结果表明,住院患者对医院设施和门诊患者对等待时间的满意度较低,提示需要进行改造,而与未参加健康保险的患者相比,参加健康保险的患者的满意度较低,这可能暗示需要进行政策改革。需要进一步加强和验证开发的工具。

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