Kane R L, Maciejewski M, Finch M
Division of Health Services Research and Policy, School of Public Health, University of Minnesota, Minneapolis 55455, USA.
Med Care. 1997 Jul;35(7):714-30. doi: 10.1097/00005650-199707000-00005.
The authors examine the relationship between three dimensions of patient satisfaction (quality of care, hospital care, and physician time) and two ways of looking at outcomes: absolute (status at 6 months after surgery) and relative (difference between baseline and follow-up status).
A total of 2,116 patients undergoing cholecystectomy were interviewed before surgery and again at 6 months. The baseline interview addressed health status (general functioning and specific symptoms) and risk factors. The follow-up interview included health status and a series of satisfaction questions. Outcomes included both overall health status and specific symptoms. Potential confounding factors, in addition to baseline status, such as demographics, casemix, and procedure type, were accounted for in the analysis.
Each of the outcomes was related significantly to each of the satisfaction scales; however, the relative outcomes were related more strongly to satisfaction than were the absolute versions. Although the regression coefficients were highly significant, none of the outcomes measures accounted for more than 8% of the explained variance in the several satisfaction scores.
Although outcomes and satisfaction are related, more goes into satisfaction than just outcomes. When determining their satisfaction with the care they have received, patients are more likely to focus on their present state of health than to consider the extent of improvement they have enjoyed.
作者探讨患者满意度的三个维度（医疗质量、医院护理和医生问诊时间）与两种看待治疗结果方式之间的关系：绝对结果（手术后6个月时的状态）和相对结果（基线状态与随访状态之间的差异）。
对总共2116例接受胆囊切除术的患者在手术前和术后6个月进行了访谈。基线访谈涉及健康状况（总体功能和特定症状）及风险因素。随访访谈包括健康状况和一系列满意度问题。结果包括总体健康状况和特定症状。分析中考虑了除基线状态外的潜在混杂因素，如人口统计学、病例组合和手术类型。
每个结果都与每个满意度量表显著相关；然而，相对结果与满意度的关联比绝对结果更强。尽管回归系数高度显著，但在几个满意度得分的解释方差中，没有任何一个结果指标的占比超过8%。
尽管结果与满意度相关，但影响满意度的因素不止结果。在确定对所接受治疗的满意度时，患者更可能关注自己当前的健康状况，而非所取得的改善程度。
