Collegium Medicum, Institute of Health Sciences, Jan Kochanowski University, Kielce, Poland.
Department of Economics and Finance, Faculty of Law and Social Sciences, Jan Kochanowski University, Kielce, Poland.
Ann Agric Environ Med. 2021 Mar 18;28(1):142-148. doi: 10.26444/aaem/132783. Epub 2021 Feb 19.
The quality of medical services and health care are complex problems with a number of various definitions, conceptual approaches, measurement tools and techniques. The most important influence on quality in primary health care has the (immaterial) human factor, the relationship between patient and doctor, medical personnel and the primary health care institution, and the skill to use new technologies to improve quality in health care.
The aim of the study is to discover the determinants of primary health care patients' dissatisfaction with the quality of medical services.
Patients with medical appointments on the day of the survey and gave their consent to participate were included in the study. A total of 901 patients of primary health care institutions [591 (65.59%) women and 310 (34.41%) men] in the Świętokrzyskie Province took part. The diagnostic poll method based on a questionnaire examining the patients' satisfaction with the quality of health services was used. Logistic regression identified the determinants of dissatisfaction of the patients.
The determinants that mostly affected the patients' dissatisfaction with medical services were: rudeness of the doctor (p=0.0001), rudeness of the rest of medical staff (p=0.0001), non-comprehensibility of information about health by the patient (p=0.004), no clear identification of the patient in the health care system (p=0.01), and difficult access to information regarding the health condition (medical documentation) (p=0.018).
Primary health care patients who participated in the study pointed to the attitude of the doctor towards a patient during a visit, and the attitude of the remaining medical personnel among the determinants of dissatisfaction with medical services.
医疗服务质量和医疗保健是一个复杂的问题，有许多不同的定义、概念方法、测量工具和技术。在初级卫生保健中，对质量最重要的影响是（无形的）人为因素，即医患关系、医务人员与初级卫生保健机构之间的关系，以及利用新技术提高医疗质量的技能。
本研究旨在发现初级卫生保健患者对医疗服务质量不满的决定因素。
在调查当天有医疗预约并同意参与的患者被纳入研究。共有 901 名初级卫生保健机构的患者[591 名（65.59%）女性和 310 名（34.41%）男性]参加了这项研究。采用基于问卷调查的诊断性民意测验方法，调查患者对卫生服务质量的满意度。逻辑回归确定了患者不满的决定因素。
影响患者对医疗服务不满的主要决定因素包括：医生的粗鲁（p=0.0001）、其余医务人员的粗鲁（p=0.0001）、患者对健康信息的理解程度（p=0.004）、患者在医疗系统中无法明确识别（p=0.01）和难以获取健康状况信息（医疗记录）（p=0.018）。
参与研究的初级卫生保健患者指出，医生在就诊期间对患者的态度，以及其余医务人员的态度是患者对医疗服务不满的决定因素之一。
