Ross C K, Steward C A, Sinacore J M
Department of Veterans Affairs, West Side Medical Center, Chicago, IL.
Med Care. 1993 Dec;31(12):1138-49. doi: 10.1097/00005650-199312000-00006.
The idea that patients will be more satisfied with health care services that are delivered to meet their preferences is central to the concept of health care marketing. Health care providers increasingly use market segmentation and target marketing to optimize the fit between their services and the consumers who receive them. This study evaluates one model for incorporation of patient preferences into the measurement of satisfaction. Using multiple regression analysis, evaluations of three dimensions of health care satisfaction, interpersonal care, technical quality, access to care accounted for 63% of the variance in overall satisfaction. Inclusion of preferences, defined as importance ranks of each dimension, did not improve ability to predict satisfaction. Four preference segments were identified: interpersonal care seekers, access/quality seekers, access seekers and quality seekers. These four subgroups differed significantly on a number of sociodemographic, health status and health service use characteristics but no significant differences were found in satisfaction between preference segments. Patient satisfaction can best be measured as quality evaluations of dimensions without regard to preferences. In considering the merits of market segmentation and target marketing, alternative satisfaction models that link preferences to health care satisfaction or the possibility that preference targeting does not lead to greater satisfaction should be evaluated.
患者会对为满足其偏好而提供的医疗保健服务更满意,这一理念是医疗保健营销概念的核心。医疗保健提供者越来越多地使用市场细分和目标营销来优化其服务与接受服务的消费者之间的匹配度。本研究评估了一种将患者偏好纳入满意度测量的模型。使用多元回归分析,对医疗保健满意度的三个维度(人际关怀、技术质量、就医便利性)的评估解释了总体满意度中63%的方差。纳入偏好(定义为每个维度的重要性排名)并没有提高预测满意度的能力。确定了四个偏好群体:人际关怀寻求者、就医便利性/质量寻求者、就医便利性寻求者和质量寻求者。这四个亚组在一些社会人口统计学、健康状况和医疗服务使用特征方面存在显著差异,但在偏好群体之间的满意度方面未发现显著差异。患者满意度最好作为对各维度的质量评估来衡量,而不考虑偏好。在考虑市场细分和目标营销的优点时,应评估将偏好与医疗保健满意度联系起来的替代满意度模型,或者偏好目标定位不会带来更高满意度的可能性。