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社会经济劣势及其对多机构放射肿瘤中心患者满意度的影响。

Socioeconomic disadvantage and its impact on patient satisfaction at a multi-site radiation oncology center.

作者信息

Loving Bailey A, Hazy Allison J, Salari Kamran F, Ye Hong, Sivapalan Shaveena, Oyeniyi Jacob F, Rutka Elizabeth, Robertson John M

机构信息

Department of Radiation Oncology, Corewell Health William Beaumont University Hospital, 3581 W 13 Mile Rd, Royal Oak, MI 48073, USA.

出版信息

Tech Innov Patient Support Radiat Oncol. 2024 Sep 6;32:100276. doi: 10.1016/j.tipsro.2024.100276. eCollection 2024 Dec.

Abstract

PURPOSE

Despite the importance of patient satisfaction (PS) on healthcare outcomes, the factors that influence PS in radiation oncology remain unexplored. This study assesses the influence of socioeconomic status (SES) on PS in radiation oncology, using the Area Deprivation Index (ADI) as a measure of SES.

METHODS

This single-institution cross-sectional study used the National Research Council (NRC) PS survey at four radiation oncology sites from 2021 to 2023. SES was measured using ADI data from the Neighborhood Atlas. Univariate (UVA) and multivariable (MVA) logistic regression analyses were conducted on recommendation scores (0-10 scale, with 9 or higher indicating a likelihood to recommend).

RESULTS

In our analysis of 7,501 survey responses, most patients were female (55.3 %), had curative treatment intent (81.5 %), and were diagnosed with breast cancer (30.4 %), with most being follow-up visits (69.0 %). Average scores for state and national ADI were 3.94 and 50.75, respectively. UVA identified factors such as curative intent (OR 1.68, p < 0.001), follow-up visits (OR 1.69, p < 0.001), and breast cancer diagnosis (OR 1.42, p = 0.018) as enhancing the likelihood of recommending the facility or provider. Those with a national ADI above the mean showed lower propensity to recommend the facility (OR 0.81, p = 0.050) or provider (OR 0.71, p = 0.002). MVA confirmed the significance of national ADI on provider recommendations (OR 0.730, p = 0.005) but not facility recommendations (OR 0.832, p = 0.089).

CONCLUSION

Patients facing higher SES disadvantages are less inclined to recommend their healthcare provider. These results highlight the role of SES in PS assessments and advocate for further investigation into how SES impacts PS and patient-provider relationships.

摘要

目的

尽管患者满意度(PS)对医疗保健结果很重要,但影响放射肿瘤学中患者满意度的因素仍未得到探索。本研究使用区域剥夺指数(ADI)作为社会经济地位(SES)的衡量指标,评估社会经济地位对放射肿瘤学中患者满意度的影响。

方法

这项单机构横断面研究使用了2021年至2023年在四个放射肿瘤学地点进行的美国国家研究委员会(NRC)患者满意度调查。使用来自邻里地图集的ADI数据来衡量社会经济地位。对推荐评分(0 - 10分制,9分或更高表示有可能推荐)进行单变量(UVA)和多变量(MVA)逻辑回归分析。

结果

在我们对7501份调查回复的分析中,大多数患者为女性(55.3%),有治愈性治疗意图(81.5%),被诊断为乳腺癌(30.4%),且大多数为随访就诊(69.0%)。州和国家ADI的平均得分分别为3.94和50.75。单变量分析确定了诸如治愈性意图(OR 1.68,p < 0.001)、随访就诊(OR 1.69,p < 0.001)和乳腺癌诊断(OR 1.42,p = 0.018)等因素会增加推荐该机构或提供者的可能性。国家ADI高于平均水平的患者推荐该机构(OR 0.81,p = 0.050)或提供者(OR 0.71,p = 0.002)的倾向较低。多变量分析证实了国家ADI对提供者推荐的重要性(OR 0.730,p = 0.005),但对机构推荐不显著(OR 0.832,p = 0.089)。

结论

面临较高社会经济地位劣势的患者不太倾向于推荐他们的医疗保健提供者。这些结果突出了社会经济地位在患者满意度评估中的作用,并倡导进一步研究社会经济地位如何影响患者满意度以及患者与提供者的关系。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9550/11414681/5a07b6eccc65/gr1.jpg

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