Isenberg S F, Stewart M G
Community Hospital, Indianapolis, IN, USA.
Am J Med Qual. 1998 Winter;13(4):188-94. doi: 10.1177/106286069801300404.
Our objective was to quantitatively measure the effect of quality improvement-based intervention on the improvement in patient satisfaction with physicians, office visits. A prospective nonrandomized case-control protocol was used at a multiple-site community-based medical and surgical office practices of members of Project Solo/Physicians Information Exchange. The study subjects were convenience samples of new and return patients seen between July 1996 and July 1997. One group of physicians (control group) surveyed patient satisfaction with office visits on two separate occasions with no intervention between the two occasions, except for seeing their own results after the first survey. A second group of physicians (intervention group) also surveyed patient satisfaction with office visits on two separate occasions, but were provided with a quality improvement poster between surveys. Changes in patient satisfaction between the two surveys were measured. The visit rating questionnaire, a nine-item patient-based questionnaire, was used to measure patient satisfaction; percentage excellent responses in the summary categories of patient access, physician attributes, and overall visit were used. Overall, 6088 patients from 59 physicians' offices participated; 3815 patients from 29 physicians in the control group, and 2273 patients from 30 physicians in the intervention group. The control group demonstrated small and nonsignificant changes in patient satisfaction between the two survey periods (0.6-1.4% increase, P = NS), and the intervention group demonstrated statistically significant improvements in patient satisfaction between the two survey periods (4.2-5.7% increase, P = 0.05-0.001). In addition, the two groups were compared directly using a stratified chi 2 analysis, and the differences were also statistically significant (chi 2 = 3.7-8.3, P = 0.05-0.004). We conclude that the use of a quality improvement-based intervention had a significant positive effect on patient satisfaction with office visits, when compared to a group of physicians who did not use any intervention.
我们的目标是定量测量基于质量改进的干预措施对提高患者对医生及门诊满意度的影响。在“单人项目/医生信息交流”成员的多个社区医疗及外科门诊实践点，采用了前瞻性非随机病例对照方案。研究对象为1996年7月至1997年7月期间就诊的新患者和复诊患者的便利样本。一组医生（对照组）在两个不同时间点调查患者对门诊的满意度，两次调查之间不进行干预，仅在第一次调查后让他们看到自己的结果。另一组医生（干预组）同样在两个不同时间点调查患者对门诊的满意度，但在两次调查之间会收到一张质量改进海报。测量两次调查之间患者满意度的变化。使用基于患者的九项门诊评分问卷来测量患者满意度；采用患者就医便利性、医生特质和总体门诊等总结类别中的优秀回答百分比。总体而言，来自59个医生办公室的6088名患者参与了研究；对照组有来自29个医生办公室的3815名患者，干预组有来自30个医生办公室的2273名患者。对照组在两个调查期之间患者满意度的变化较小且无统计学意义（提高0.6 - 1.4%，P = 无统计学意义），而干预组在两个调查期之间患者满意度有统计学显著提高（提高4.2 - 5.7%，P = 0.05 - 0.001）。此外，使用分层卡方分析直接比较两组，差异也具有统计学意义（卡方 = 3.7 - 8.3，P = 0.05 - 0.004）。我们得出结论，与未采取任何干预措施的一组医生相比，基于质量改进的干预措施对患者对门诊的满意度有显著的积极影响。
