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基层医疗中的消化不良:感知到的病因、改善原因及对医疗服务的满意度

Dyspepsia in primary care: perceived causes, reasons for improvement, and satisfaction with care.

作者信息

Kurata J H, Nogawa A N, Chen Y K, Parker C E

机构信息

San Bernardino County Medical Center, CA, USA.

出版信息

J Fam Pract. 1997 Mar;44(3):281-8.

PMID:9071248
Abstract

BACKGROUND

While dyspepsia is a common problem in primary care populations, very little is known about patient perceptions of medical care for this disease. The present study of patients with dyspepsia treated by primary care physicians looks at causes, procedures, and reasons for improvement from the patient's viewpoint and relates these factors to patient satisfaction with family physicians' medical care.

METHODS

Medical chart and billing data were collected for 545 adult patients who visited five family health centers for digestive complaints during a 6-month period in 1993. A questionnaire was completed by 288 patients 6 to 8 weeks after patient's index visit. Baseline findings are reported.

RESULTS

The two most common causes of gastrointestinal problems were attributed to stress or anxiety (58%) and diet (46%). Between the time of the index visit and the baseline survey, 48% reported that they had recovered or improved. Of those who recovered or improved, most (75%) credited "taking GI medicine" followed by change in diet (44%). Patients who reported recovery or improvement of their gastrointestinal complaints (P < .001) and older patients (P = .032) were the most satisfied with overall medical care. Satisfaction with medical care was not associated with insurance coverage, procedures done, race, antiulcer medication treatment, diagnosis, general health status, or sex.

CONCLUSIONS

Specific health status, ie, improvement of gastrointestinal (GI) problems, predicted patient satisfaction for 70% of cases in this study. Most patients who improved credited GI medicines for their improvement, and those who improved were more satisfied with their medical care.

摘要

背景

消化不良是基层医疗人群中的常见问题,但对于患者对这种疾病医疗护理的看法却知之甚少。本项针对由基层医疗医生治疗的消化不良患者的研究,从患者的角度审视病因、治疗过程及病情改善的原因,并将这些因素与患者对家庭医生医疗护理的满意度相关联。

方法

收集了1993年6个月期间到5家家庭健康中心就诊消化系统疾病的545名成年患者的病历和计费数据。288名患者在首次就诊后6至8周完成了一份问卷。报告了基线调查结果。

结果

胃肠道问题最常见的两个原因是压力或焦虑(58%)和饮食(46%)。在首次就诊至基线调查期间,48%的患者报告病情已康复或有所改善。在康复或改善的患者中,大多数(75%)认为“服用胃肠药物”有效,其次是饮食改变(44%)。报告胃肠道不适症状康复或改善的患者(P < .001)和老年患者(P = .032)对整体医疗护理最为满意。对医疗护理的满意度与保险覆盖范围、所做的检查、种族、抗溃疡药物治疗、诊断、总体健康状况或性别无关。

结论

特定的健康状况,即胃肠道问题的改善,在本研究中可预测70%病例的患者满意度。大多数病情改善的患者认为胃肠药物对其病情改善有作用,且病情改善的患者对医疗护理更满意。

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