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使用通用实践评估问卷的修改版评估巴林初级医疗保健中的服务质量维度及其对患者满意度的影响。

Assessing Service Quality Dimensions and Their Effect on Patients Satisfaction in Bahrain Primary Healthcare Using a Modified Version of the General Practice Assessment Questionnaire.

作者信息

Almuhanadi Shawq, Alhammadi Hassan, Suresh Aaruni, Al Alawi Samah

机构信息

General Practice Clinic.

Medical Commission Family Physician.

出版信息

Patient Prefer Adherence. 2020 Dec 31;14:2541-2549. doi: 10.2147/PPA.S285440. eCollection 2020.

Abstract

OBJECTIVE

This study aimed to have an instrument for assessing Bahrain healthcare. For such purpose, we used the General Practice Assessment Questionnaire (GPAQ-R2) and a modified shorter version of it, GPAQ-R2-BDF. The GPAQ-R2-BDF was modified based on the healthcare system and the cultural behavior in Bahrain.

SUBJECTS AND METHODS

This cross-sectional study was conducted at the general practice (GP) of the Bahrain Defense Force (BDF) Hospital from March 2018 to April 2018. Five hundred and twenty patients visiting the clinics completed the original GPAQ-R2 questionnaire. A validity, reliability, and rotated factor analysis were performed on the original and modified questionnaire. Patients' characteristics such as age, gender, long-standing health conditions, and employment status were recorded. The score responses of the questionnaire were analyzed, and areas of weakness were identified.

RESULTS

The validity, reliability, and correlation matrix values of the original GPAQ-R2 in the GP access and GP practice components were unsatisfactory in BDF hospital assessment. However, the modified GPAQ-R2-BDF revealed higher overall validity, reliability, and correlation matrix, and the rotated factor analysis showed values between 0.704 and 0.928. Furthermore, the reliability values ranged from 0.77 to 0.936. As for patients' satisfaction scores were highest (90%) in confidence and enablement, and doctor care but lowest in GP access, and GP practice (77%) (P<0.001). On the other hand, patients with long-standing health conditions were less satisfied with doctor care, confidence and enablement, and GP access (p<0.05-0.01).

CONCLUSION

The present findings demonstrated high reliability and validity for the GPAQ-R2-BDF, which supports its use to assess Bahrain's GP healthcare system. Furthermore, such an instrument should be adapted in a longitudinal research design to assess Bahrain's healthcare system better. Lastly, BDF hospital healthcare clinics showed concerns in GP access, GP practice, and quality services for patients with long-standing health conditions requiring strategic interventions to reach better quality services.

摘要

目的

本研究旨在获得一种评估巴林医疗保健的工具。为此,我们使用了全科医疗评估问卷(GPAQ-R2)及其修改后的较短版本GPAQ-R2-BDF。GPAQ-R2-BDF是根据巴林的医疗保健系统和文化行为进行修改的。

受试者与方法

本横断面研究于2018年3月至2018年4月在巴林国防军(BDF)医院的全科医疗科室进行。520名到诊所就诊的患者完成了原始的GPAQ-R2问卷。对原始问卷和修改后的问卷进行了效度、信度和旋转因子分析。记录患者的年龄、性别、长期健康状况和就业状况等特征。分析问卷的得分回答,并确定薄弱环节。

结果

在BDF医院评估中,原始GPAQ-R2在全科医疗可及性和全科医疗实践部分的效度、信度和相关矩阵值不令人满意。然而,修改后的GPAQ-R2-BDF显示出更高的总体效度、信度和相关矩阵,旋转因子分析显示值在0.704至0.928之间。此外,信度值范围为0.77至0.936。至于患者满意度得分,在信心与赋能以及医生关怀方面最高(约90%),但在全科医疗可及性和全科医疗实践方面最低(约77%)(P<0.001)。另一方面,患有长期健康状况的患者对医生关怀、信心与赋能以及全科医疗可及性的满意度较低(p<0.05-0.01)。

结论

本研究结果表明GPAQ-R2-BDF具有较高的信度和效度,支持其用于评估巴林的全科医疗保健系统。此外,应在纵向研究设计中采用这样的工具,以更好地评估巴林的医疗保健系统。最后,BDF医院的医疗诊所显示出在全科医疗可及性、全科医疗实践以及为患有长期健康状况的患者提供优质服务方面存在问题,需要采取战略干预措施以实现更高质量的服务。

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