Allen W W, Stoline M R, Yang I, Barrett L
Kalamazoo Family Medicine, Michigan State University, USA.
Fam Med. 1996 Jun;28(6):429-33.
Patient satisfaction is an important component used to assess quality of health care. Limited access to and choice of physicians, perception of receiving second-class care by recipients, and possible negative caregiver attitudes could cause Medicaid enrollees to be less satisfied with their physicians than other patients.
A cross-sectional survey was conducted of 603 patients visiting four family practice residency clinics during a 1-week period that yielded a 72% response or 436 usable surveys. The 39-item survey included basic demographics (age, gender, site, and first-time visit status), five of Ware's "dimensions" of patient satisfaction, a composite score for life satisfaction, a measure of patient confidence in the local medical care community, and questions about how patients felt they were treated, based on insurance type. It was hypothesized that Medicaid enrollees would not be as satisfied with their care as other patients.
The study hypothesis was rejected after using two-sample t tests and regression analyses. Lower levels of patient satisfaction were not found in Medicaid enrollees, even after adjusting for the effects of differing demographic characteristics, possible different life satisfaction levels, and possible different levels of confidence in the local medical care community.
The results of this study show that enrollment in Medicaid did not result in lower levels of patient satisfaction. Future research about these issues in settings other than family practice residency clinics is needed.
患者满意度是评估医疗保健质量的一个重要组成部分。获得医生服务的机会有限、医生选择受限、接受者认为受到二等护理以及护理人员可能持有的负面态度，可能导致医疗补助计划参保者对其医生的满意度低于其他患者。
在为期1周的时间内，对603名前往四家家庭医学住院医师诊所就诊的患者进行了横断面调查，得到了72%的回应率，即436份可用调查问卷。这份包含39个项目的调查问卷包括基本人口统计学信息（年龄、性别、就诊地点和首次就诊状态）、韦尔患者满意度的五个“维度”、生活满意度综合得分、患者对当地医疗保健社区信心的衡量指标，以及基于保险类型询问患者对自身治疗感受的问题。研究假设是医疗补助计划参保者对其护理的满意度不如其他患者。
在使用双样本t检验和回归分析后，研究假设被驳回。即使在调整了不同人口统计学特征、可能不同的生活满意度水平以及对当地医疗保健社区可能不同的信心水平的影响之后，也未发现医疗补助计划参保者的患者满意度较低。
本研究结果表明，参加医疗补助计划并不会导致患者满意度降低。需要在家庭医学住院医师诊所以外的环境中对这些问题进行未来研究。
