Salisbury C
Department of Primary Health Care and General Practice, Imperial College School of Medicine at St Mary's, London.
BMJ. 1997 May 31;314(7094):1594-8. doi: 10.1136/bmj.314.7094.1594.
To assess patients' satisfaction with out of hours care by a general practice cooperative compared with that by a deputising service.
Postal questionnaire survey.
A general practice cooperative in London and a deputising service operating in an overlapping area.
Weighted samples of patients receiving telephone advice, a home visit, or attending a primary care centre after contacting either service in an eight week period.
Patients' overall satisfaction and scores for specific aspects of satisfaction. Satisfaction with telephone advice or attendance at centre compared with home visit. Relation between satisfaction and patient's age, sex, ethnic group, car ownership, preference for consulting own doctor, and expectation of a visit.
The overall response rate was 67% (1555/2312). There was little difference in overall satisfaction between patients contacting the cooperative or the deputising service, but patients contacting the latter were less satisfied with the explanation and advice received and the wait for a visit. There were significant differences between patients in different age and ethnic groups, with white patients and those aged over 60 years being more satisfied. Lower scores for overall satisfaction were reported by patients who received telephone advice, those who would have preferred to see their own doctor or who originally wanted a home visit, and those who waited longer for their consultation. Overall levels of patients' satisfaction seemed to be lower than previously reported.
There were larger differences in satisfaction between different groups of patients than between different models of organisation for out of hours care. A shift to a service based predominantly on telephone advice may lead to increased patient dissatisfaction.
评估患者对全科医疗合作社提供的非工作时间医疗服务的满意度,并与代理服务进行比较。
邮寄问卷调查。
伦敦的一家全科医疗合作社以及在重叠区域运营的代理服务机构。
在八周内联系过这两种服务之一并接受电话咨询、上门就诊或前往初级保健中心就诊的患者的加权样本。
患者的总体满意度以及满意度特定方面的得分。电话咨询或在中心就诊与上门就诊的满意度比较。满意度与患者年龄、性别、种族、是否拥有汽车、是否倾向于咨询自己的医生以及就诊期望之间的关系。
总体回复率为67%(1555/2312)。联系合作社或代理服务的患者在总体满意度上差异不大,但联系后者的患者对所获得的解释和建议以及就诊等待时间不太满意。不同年龄和种族的患者之间存在显著差异,白人患者和60岁以上的患者更满意。接受电话咨询的患者、原本希望看自己的医生或最初希望上门就诊的患者以及等待就诊时间更长的患者总体满意度得分较低。患者的总体满意度水平似乎低于先前报告的水平。
不同患者群体之间的满意度差异大于非工作时间医疗服务不同组织模式之间的差异。转向主要基于电话咨询的服务可能会导致患者满意度提高。