Schwartz L R, Overton D T
Ann Emerg Med. 1987 Aug;16(8):857-61. doi: 10.1016/s0196-0644(87)80522-x.
We conducted an analysis of all complaints received in a busy suburban emergency department during 1985. All complaints were handled in a standardized fashion, and were categorized as billing, physician, nursing, or miscellaneous. Data were expressed as a "complaint frequency" (complaints per 1,000 patient visits). Complaints were analyzed for the following characteristics: reason, gender of the patient, gender of the complaining party, relationship of the complaining party to the patient, health care provider, patient age, and patient disposition. The chi-square method was used to identify characteristics associated with a high risk for complaints. There were a total of 244 complaints, arising from 64,910 patient visits, yielding an overall complaint frequency of 3.8. The largest number of complaints (135), involved billing (frequency, 2.0). The most common (60) was insurance carrier rejection of the bill as a nonemergency. The next most common billing complaint (25) was a charge mistakenly billed too high by the ED. There were 70 complaints regarding emergency physicians, for a complaint frequency of 1.1. Of these, 17 were due to a perceived lack of communication with the patient, the patient's family, or the patient's private physician. Eighteen complaints were regarding a perceived misdiagnosis. One physician had a significantly higher complaint frequency than the group as a whole (P less than .005). There were 17 complaints regarding the nursing staff, for a complaint frequency of 0.2. Twenty-two complaints were classified as miscellaneous. Expressing data as complaint frequencies allows comparison of trends in a department, staff members, and different EDs with varied patient populations.(ABSTRACT TRUNCATED AT 250 WORDS)
我们对1985年一家繁忙的郊区急诊科收到的所有投诉进行了分析。所有投诉均以标准化方式处理,并分为账单、医生、护理或其他类别。数据以“投诉频率”(每1000次患者就诊的投诉数)表示。对投诉的以下特征进行了分析:原因、患者性别、投诉方性别、投诉方与患者的关系、医疗服务提供者、患者年龄和患者处置情况。采用卡方方法来确定与高投诉风险相关的特征。共有244起投诉,来自64910次患者就诊,总体投诉频率为3.8。投诉数量最多的是账单问题(135起),频率为2.0。最常见的(60起)是保险公司将账单作为非紧急情况拒绝支付。其次最常见的账单投诉(25起)是急诊科错误地将费用开得过高。关于急诊医生的投诉有70起,投诉频率为1.1。其中,17起是由于感觉与患者、患者家属或患者的私人医生缺乏沟通。18起投诉是关于误诊。有一位医生的投诉频率明显高于整个群体(P小于0.005)。关于护理人员的投诉有17起,投诉频率为0.2。22起投诉被归类为其他。将数据表示为投诉频率有助于比较一个科室、工作人员以及不同患者群体的急诊科的趋势。(摘要截取至250字)