NOVA University of Lisbon, National School of Public Health.
University of Lisbon, Institute of Social Sciences.
Medicine (Baltimore). 2021 Mar 19;100(11):e25133. doi: 10.1097/MD.0000000000025133.
The purpose of this research was to identify whether a certain set of drivers of satisfaction/perceived quality of healthcare (PQHC) could indirectly affect patients' confidence/trust in the emergency department (ED).Patients were seen at an ED in the public hospital in Lisbon, Portugal between January and December 2016. Data were collected between May and November 2017, using a questionnaire, by mail or e-mail. The total sample size comprised 382 patients. The data analysis included structural equation modeling to test the conceptual model with specific drivers of satisfaction/PQHC (privacy; accessibility and availability; doctors; meeting expectations; waiting time for triage [perception]; waiting time to be called back by the doctor following examinations and/or tests [perception]; information about possible delays in receiving treatment/waiting times) and with the main outcome (confidence/trust in the ED) using path analysis.The analysis of the coefficients revealed that all the mediated paths are statistically significant (P ≤ .05). Although, altogether, the direct paths did not prove statistically significant (P > .05), the overall satisfaction with doctors (P ≤ .01) and meeting expectations (P = .01) can still directly explain the confidence/trust in the ED without the mediating role of satisfaction and PQHC. Hence, overall satisfaction with doctors and meeting expectations can influence, both directly and indirectly, confidence/trust in the ED. All other variables can only indirectly affect confidence/trust in the ED, either through PQHC or through satisfaction.Even though there are more variables that influence confidence/trust in the ED through PQHC (1)waiting time to be called back by the doctor following examinations and/or tests [perception]; 2) privacy; 3) accessibility and availability; 4) doctors; 5) meeting expectations than through satisfaction (1)waiting time for triage [perception]; 2) information about possible delays in receiving treatment/waiting times; 3) doctors; 4) meeting expectations), we observe the strongest contribution in the mediation model through satisfaction, which reveals its dominant role over PQHC.
这项研究的目的是确定一组特定的医疗保健满意度/感知质量（PQHC）驱动因素是否会间接影响患者对急诊部（ED）的信心/信任。患者于 2016 年 1 月至 12 月在葡萄牙里斯本的公立医院 ED 就诊。数据于 2017 年 5 月至 11 月间通过问卷收集，以邮件或电子邮件的形式发送。总样本量为 382 名患者。数据分析包括结构方程模型，以使用满意度/PQHC 的特定驱动因素（隐私；可及性和可用性；医生；满足期望；分诊等待时间[感知]；在检查和/或测试后被医生召回的等待时间[感知]；有关治疗/等待时间延迟的信息）和主要结果（对 ED 的信心/信任）来测试概念模型，使用路径分析。系数分析表明，所有中介路径均具有统计学意义（P≤.05）。尽管如此，尽管所有直接路径都没有统计学意义（P>.05），但对医生的总体满意度（P≤.01）和满足期望（P=.01）仍然可以直接解释对 ED 的信心/信任，而无需满意度和 PQHC 的中介作用。因此，对医生的总体满意度和满足期望可以直接和间接影响对 ED 的信心/信任。所有其他变量只能通过 PQHC 或满意度间接影响对 ED 的信心/信任。（1）检查和/或测试后被医生召回的等待时间[感知]；2）隐私；3）可及性和可用性；4）医生；5）满足期望，而不是通过满意度（1）分诊等待时间[感知]；2）有关治疗/等待时间延迟的信息；3）医生；4）满足期望），我们观察到通过满意度的中介模型中最强的贡献，这表明其在 PQHC 中的主导作用。
