Rosenheck R, Wilson N J, Meterko M
Department of Veterans Affairs Northeast Program Evaluation Center, West Haven, CT 06516, USA.
Psychiatr Serv. 1997 Dec;48(12):1553-61. doi: 10.1176/ps.48.12.1553.
This study examines patient- and facility-related determinants of satisfaction with inpatient mental health services.
A random sample of veterans discharged from Department of Veterans Affairs inpatient units with primary diagnoses of a psychiatric or substance use disorder (N = 13,574) were mailed a 73-item questionnaire that addressed aspects of their recent hospital experience. Multiple regression analysis was used to evaluate the relationship between patient and hospital characteristics and both the likelihood of responding to the survey and aspects of satisfaction measured by 14 subscales.
A total of 4,968 veterans, or 37 percent, mailed back responses to the questionnaire. Respondents were older than nonrespondents and were more likely to be white and married and to have nonpsychotic disorders other than substance use disorders. The strongest and most consistent predictors of satisfaction were older age and better self-reported health. Longer length of stay was also associated with greater satisfaction on a majority of subscales. Findings among female and minority veterans were mixed across measures. Large facilities and facilities that specialize in mental health treatment had lower levels of satisfaction than others. Patient characteristics accounted for more of the variance in satisfaction than did facility characteristics.
Older and healthier patients reported greater satisfaction with mental health care services. Accurate comparison of patient satisfaction between facilities requires that adjustments be made for differences in patient characteristics. Large facilities may need to make special efforts to personalize their services.
本研究探讨与住院心理健康服务满意度相关的患者及机构因素。
从退伍军人事务部住院部出院的退伍军人中随机抽取样本,这些退伍军人的主要诊断为精神疾病或物质使用障碍(N = 13574),向他们邮寄了一份包含73个条目的问卷,该问卷涉及他们近期住院经历的各个方面。多元回归分析用于评估患者和医院特征与调查回复可能性以及由14个分量表测量的满意度方面之间的关系。
共有4968名退伍军人(占37%)寄回了问卷回复。回复者比未回复者年龄更大,更可能是白人、已婚,且患有除物质使用障碍外的非精神病性障碍。满意度最强且最一致的预测因素是年龄较大和自我报告的健康状况较好。住院时间较长在大多数分量表上也与更高的满意度相关。女性退伍军人和少数族裔退伍军人在各项指标上的结果不一。大型机构和专门从事心理健康治疗的机构的满意度低于其他机构。患者特征比机构特征在满意度差异中占更大比例。
年龄较大且健康状况较好的患者对心理健康护理服务的满意度更高。要准确比较不同机构间的患者满意度,需要针对患者特征的差异进行调整。大型机构可能需要特别努力使服务个性化。