Meetz H K, Freeman H E, Marcus M, Hurst E F
UCLA School of Dentistry 90024-1668.
J Dent Educ. 1987 Nov;51(11):646-51.
As the health care system becomes more impersonal, competitive, and cost conscious, there is a potential for increased dissatisfaction with health care providers. This paper describes the use of content analysis to examine aspects of patient dissatisfaction with delivery of health services in a capitated dental plan. All written complaints from three regions of California from June 1984 to June 1986 were collected, and a content analysis was performed on these letters. The rates of grievances differ substantially across regions; however, three regions were similar in their grievance patterns. Access to care was the single largest category of concern, and these grievances were registered because patients had to wait for an appointment (35 percent) or had to wait in the office (32 percent) to receive care. Provider technical competence was the second largest category. Significant variables from a logistic regression that predicts complaint status of an eligible member are (1) years covered, (2) age, and (3) income. The grievance rate and grievance categories described in this study can help define new strategies and policies in the overall mission of a dental capitation organization.
随着医疗保健系统变得更加缺乏人情味、竞争激烈且注重成本，患者对医疗服务提供者的不满可能会增加。本文描述了如何运用内容分析法来审视在按人头付费的牙科保险计划中患者对医疗服务提供不满的各个方面。收集了1984年6月至1986年6月加利福尼亚三个地区的所有书面投诉，并对这些信件进行了内容分析。不同地区的投诉率差异很大；然而，三个地区的投诉模式相似。获得医疗服务是最主要的关注类别，提出这些投诉是因为患者需要等待预约（35%）或在候诊室等待（32%）才能接受治疗。提供者的技术能力是第二大类别。逻辑回归中预测符合条件成员投诉状态的显著变量有：（1）参保年限，（2）年龄，以及（3）收入。本研究中描述的投诉率和投诉类别有助于在牙科按人头付费组织的总体使命中确定新的策略和政策。
