Kang Yu Sunny, Tzeng Huey-Ming, Zhang Ting
School of Health and Human Services, College of Public Affairs, University of Baltimore, Liberal Arts and Policy Building, Baltimore, MD, USA.
The University of Texas Medical Branch, School of Nursing, Galveston, TX, USA.
J Patient Exp. 2020 Aug;7(4):607-614. doi: 10.1177/2374373519862933. Epub 2019 Sep 23.
Hospital patient satisfaction has been a salient policy concern. We examined rurality's impact on patient satisfaction measures.
We examined patients (age 50 and up) from 65 rural and urban hospitals in Massachusetts, using the merged data from 2007 American Hospital Association Annual Survey, State Inpatient Database and Survey of Patients' Hospital Experiences, utilizing Hierarchical binary logistic regression analyses to examine the rural disparities in patient satisfaction measures.
Relative to the urban location, rurality reduced the likelihood of cleanliness of environment (odds ratio = 0.66, 95% confidence interval: [0.63-0.70]); but increased the likelihood of staff responsiveness and quietness. Compared to Caucasian counterparts, Hispanic patients were less likely to reside in a quiet hospital. Compared to other payments, Medicare or Medicaid coverage each reduced the likelihood of staff responsiveness and cleanliness. Compared to other diagnoses, depressive or psychosis disorders predicted smaller odds in responsiveness and cleanliness. Anxiety diagnosis reduced the likelihood of cleanness and quietness. At the facility level, higher registered nurse full-time equivalent (FTE)s or being a teaching hospital increased the likelihood of all measures.
Relative to the urban counterparts, rural patients experienced lower likelihood of staff responsiveness after adjusting for other factors. Compared to Caucasian patients, Hispanic patients were less likely to reside in quiet hospital environment. Research is needed to further explore the basis of these disparities. Mental health diagnoses in depressive and psychosis disorders also called upon further studies in special care needs.
医院患者满意度一直是一项备受关注的政策问题。我们研究了农村地区对患者满意度指标的影响。
我们对马萨诸塞州65家农村和城市医院的患者（年龄在50岁及以上）进行了研究，使用了2007年美国医院协会年度调查、州住院患者数据库和患者医院体验调查的合并数据，采用分层二元逻辑回归分析来研究患者满意度指标中的农村差异。
相对于城市地区，农村地区降低了环境清洁的可能性（优势比=0.66，95%置信区间：[0.63 - 0.70]）；但提高了工作人员响应能力和安静程度的可能性。与白人患者相比，西班牙裔患者在安静医院就医的可能性较小。与其他支付方式相比，医疗保险或医疗补助覆盖的患者，工作人员响应能力和环境清洁的可能性均降低。与其他诊断相比，抑郁或精神障碍诊断预测在响应能力和环境清洁方面的几率较小。焦虑诊断降低了环境清洁和安静程度的可能性。在机构层面，较高的注册护士全职等效人员（FTE）或作为教学医院会增加所有指标的可能性。
相对于城市地区的患者，在调整其他因素后，农村患者获得工作人员响应的可能性较低。与白人患者相比，西班牙裔患者在安静医院环境中就医的可能性较小。需要进一步研究以探索这些差异的根源。抑郁和精神障碍方面的心理健康诊断也需要对特殊护理需求进行进一步研究。
