Faculty of Dentistry, McGill University, 2001 Avenue McGill College #500, Montreal, QC, H3A 1G1, Canada.
Sri Aurobindo College of Dentistry, Sanwer Road, Indore, India.
BMC Oral Health. 2021 May 15;21(1):261. doi: 10.1186/s12903-021-01613-0.
BACKGROUND: Identifying spatial variation in patient satisfaction is essential to improve the quality of care. Thus, the objective of this study was to investigate rural-urban disparities in patient satisfaction and to determine the factors that could influence satisfaction with oral health care. METHODS: Data from 1788 parents/caregivers of children who participated in the Quebec Ministry of Health clinical study were subject to secondary analysis. The Perneger model of patient satisfaction was used as the conceptual framework for the study. Satisfaction with oral health care was measured using the WHO-sponsored International Collaborative Study of Oral Health Outcomes (ICS-II). Explanatory variables included predisposing factors and enabling resources. Statistical analyses included descriptive statistics, as well as bivariate and linear regression models. RESULTS: Individuals with higher income, dental insurance coverage, having a family dentist, reporting ease in finding a dentist, and having access to a private dental clinic were more satisfied with oral health care (p < 0.001). There were statistically significant differences between rural and urban Quebec residents in their ratings of patient satisfaction on four items, including dental office location (p = 0.013), dental equipment (p = 0.016), cost of dental treatment (p < 0.001), and cleanliness of dental office (p = 0.004), with greater satisfaction for urban dwellers. The multiple linear regression model showed that major determinants of patient satisfaction were being born in Canada, income ≥ 40,000$ CAD, having a family dentist, and having visited the dentist in the last year for regular checkups. However, ethnicity, having difficulty finding a dentist, and being in need of dental treatment negatively influenced patient satisfaction with oral health care. CONCLUSIONS: These findings suggest that Quebec rural-urban disparity exists in patient satisfaction with care and that determinants of health influence this outcome. Intensive and powerful knowledge dissemination activities are needed to mobilize policymakers in implementing public health strategies to reduce this disparity.
背景：识别患者满意度的空间变化对于提高医疗质量至关重要。因此，本研究的目的是调查农村和城市地区患者满意度的差异，并确定可能影响口腔保健满意度的因素。
方法：对参与魁北克省卫生部临床研究的 1788 名儿童的家长/照顾者的数据进行二次分析。使用 Perneger 患者满意度模型作为研究的概念框架。使用世界卫生组织（WHO）赞助的国际口腔健康结果合作研究（ICS-II）来衡量口腔保健的满意度。解释变量包括倾向因素和实现资源。统计分析包括描述性统计，以及双变量和线性回归模型。
结果：收入较高、有牙科保险、有家庭牙医、报告看牙医容易、能获得私人牙科诊所的人对口腔保健的满意度更高（p<0.001）。在四个项目上，农村和城市魁北克居民的患者满意度评分存在统计学上的显著差异，包括牙科诊所的位置（p=0.013）、牙科设备（p=0.016）、牙科治疗费用（p<0.001）和牙科诊所的清洁度（p=0.004），城市居民的满意度更高。多元线性回归模型显示，患者满意度的主要决定因素是在加拿大出生、收入≥40,000 加元、有家庭牙医以及去年因定期检查而看牙医。然而，种族、看牙医有困难以及需要牙科治疗会对口腔保健的满意度产生负面影响。
结论：这些发现表明，魁北克农村和城市地区在患者对护理的满意度方面存在差异，健康决定因素会影响这一结果。需要开展密集和有力的知识传播活动，动员政策制定者实施公共卫生战略，以减少这种差异。
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