白內(nèi)障日間手術患者滿意度調(diào)查及影響因素分析
發(fā)布時間：2019-05-23 16:17
【摘要】：目的:通過對山西省某醫(yī)院白內(nèi)障日間手術的患者進行調(diào)查,了解其滿意度現(xiàn)狀,分析其滿意度的影響因素,找到醫(yī)療服務過程中的薄弱環(huán)節(jié),并提出具體改進措施,從而改善患者就醫(yī)體驗,提高患者滿意度,探尋適合醫(yī)院開展日間手術的流程和管理模式,推動日間手術的持續(xù)性發(fā)展。方法:選取2016年7月~12月就診于山西省某醫(yī)院的白內(nèi)障日間手術后復查,且符合條件接受問卷調(diào)查的患者536人,收回有效問卷524份,有效率97.8%。通過問卷調(diào)查白內(nèi)障日間手術患者的人口社會學特征、日間手術知曉情況和日間手術患者滿意度。采用SPSS23.0軟件進行統(tǒng)計分析,運用統(tǒng)計描述、卡方檢驗和二元多因素logistic回歸方法分析白內(nèi)障日間手術患者滿意度現(xiàn)狀及其影響因素,檢驗水準為0.05。結果:1.白內(nèi)障日間手術患者人口社會學特征顯示:本次調(diào)查患者中,男性214人,女性310人;年齡最小的30歲,最大的88歲,平均年齡為70.1±11.5歲。2.日間手術知曉情況調(diào)查結果顯示:(1)經(jīng)X~2檢驗,手術后日間手術知曉率高于就診前,差別有統(tǒng)計學意義(X~2=135.666,P0.001)。(2)了解日間手術的途徑排名前三位:醫(yī)生介紹(71.0%)、親戚朋友告知(20.0%)、術后復查患者相互告知(6.1%)。(3)選擇日間手術的主要原因排名前三位:縮短住院等候時間和治療時間(31.5%)、可以較早回家康復,對自己和家人的生活影響較小(18.3%)、醫(yī)生推薦(17.6%)。(4)經(jīng)X~2檢驗,不同性別的白內(nèi)障患者對日間手術的知曉率不同,男性高于女性,差別有統(tǒng)計學意義(X_(性別)~2=10.555,p=0.001);不同職業(yè)的白內(nèi)障患者對日間手術的知曉率總體分布不同,離退休人員知曉率最高,差別有統(tǒng)計學意義(X_(職業(yè))~2=19.806,p=0.003);不同平均月收入的白內(nèi)障患者對日間手術的知曉率總體分布不同,隨著收入的增高知曉率增高,差別有統(tǒng)計學意義(X_(平均月收入)~2=14.069,p=0.001);不同醫(yī)保形式的白內(nèi)障患者對日間手術的知曉率總體分布不同,參加城鎮(zhèn)職工醫(yī)療保險的患者知曉率最高,差別有統(tǒng)計學意義(X_(醫(yī)保形式)~2=14.140,p=0.003)。3.白內(nèi)障日間手術患者滿意度調(diào)查結果顯示:患者對醫(yī)院總體滿意度為91.2%。對就診流程的滿意度為88.9%;對醫(yī)療質(zhì)量的滿意度為98.8%;對醫(yī)患溝通的滿意度為92.9%;對醫(yī)德醫(yī)風的滿意度為97.5%;對醫(yī)療費用的滿意度為76.7%;對醫(yī)院環(huán)境的滿意度為92.3%。4.白內(nèi)障日間手術患者滿意度二元多因素logistic分析結果顯示:文化程度、有無既往手術史、術后對日間手術了解程度對患者滿意度產(chǎn)生影響(p0.05)。在文化程度中,以大專/本科的患者為參照分類,中專/高中或初中及以下文化程度的患者與其均存在顯著差異,or值分別為3.771、2.546,95%ci分別為(1.513,9.400)、(1.095,5.919),表示文化程度高的患者對日間手術滿意度低;有既往手術史的患者與無既往手術史的患者對滿意度存在顯著差異,or值為4.763,95%ci為(1.729,13.122),有既往手術史的患者滿意度是無既往手術史患者滿意度的4.763倍;手術后患者對日間手術了解程度與患者滿意度存在顯著差異,or值為0.411,95%ci為(0.200,0.845),表明不太了解日間手術的術后患者較了解日間手術的術后患者滿意度高。結論:1.山西某醫(yī)院白內(nèi)障日間手術患者總體滿意度為91.2%。在六個維度的滿意度評價中,就診流程和醫(yī)療費用的患者滿意度相對較低。2.白內(nèi)障日間手術患者中,不同性別、職業(yè)、平均月收入、醫(yī)療保險形式對患者知曉率存在影響;不同文化程度、有無既往手術史和手術后對日間手術了解程度對患者滿意度均存在影響。3.建議醫(yī)院加大日間手術宣傳力度,增加民眾知曉率;多渠道降低醫(yī)療費用,完善醫(yī)保政策;優(yōu)化醫(yī)療服務流程,改變醫(yī)療管理模式;針對不同特點的患者提供個性化服務,提高患者滿意度。
[Abstract]:Objective: To study the status of the patient's satisfaction, to analyze the influencing factors of the satisfaction degree, to find the weak link in the medical service process, and to put forward concrete improvement measures to improve the patient's medical experience through the investigation of the patients in a hospital in a hospital in Shanxi province. To improve the patient's satisfaction, explore the process and management mode suitable for the day operation in the hospital, and promote the continuous development of the day operation. Methods: From July to December,2016, a group of 536 patients who were admitted to a hospital in Shanxi province were reviewed, and 536 patients were eligible to receive the questionnaire. The effective rate was 52.4% and the effective rate was 97.8%. The demographic and social characteristics, day-to-day and day-to-day operation of patients with cataract surgery were investigated by questionnaire. Statistical analysis, statistical description, chi-square test and multi-factor logistic regression were used to analyze the status of the patient's satisfaction and the influencing factors, and the level of the test was 0.05. Results:1. The demographic and social characteristics of the patients with cataract surgery showed that in this survey, there were 214 males and 310 females, with a minimum age of 30 and a maximum of 88 years, with an average age of 70.1 to 11.5 years. The results of the study of day-to-day operation showed that: (1) After X-2 test, the rate of postoperative day-to-day operation was higher than that before treatment (X ~ 2 = 135.666, P 0.001). (2) To know the way of day-to-day operation was the first three: the doctor's introduction (71.0%), the relatives and relatives (20.0%), and the post-operative reexamination patients (6.1%). (3) The main reason for choosing daytime operation was the first three: to shorten the waiting time of the hospital and the treatment time (31.5%), to be able to go home earlier and to be less affected by the life of the family and the family (18.3%), and the doctor recommended (17.6%). (4) In the X ~ (2) test, the patients with different sex have different knowledge of the daytime operation, the male is higher than that of the female, the difference is of statistical significance (X _ (sex) ~ 2 = 10.555, p = 0.001), and the overall distribution of the patients with different occupational cataract is different from that of the daytime operation. The knowledge of the retired personnel is the highest, the difference is of statistical significance (X _ (occupation) ~ 2 = 19.806, p = 0.003); the average distribution of the average monthly income of the cataract patients is different from that of the daytime operation, and with the increase of the increase of income, The difference is of statistical significance (X _ (average monthly income) ~ 2 = 14.069, p = 0.001); the average distribution of the knowledge of the patients with cataract in different medical insurance forms is different from that of daytime operation, and the knowledge of the patients participating in the medical insurance for urban workers is the highest. The difference was statistically significant (X _ (medical insurance form) ~ 2 = 14.140, p = 0.003). The results of the patient's satisfaction survey showed that the overall satisfaction of the patients was 91.2%. The satisfaction of the medical treatment process was 88.9%, the satisfaction of the medical quality was 98.8%, the satisfaction of the doctor-patient communication was 92.9%, the satisfaction of the medical ethics was 97.5%, the satisfaction of the medical expenses was 76.7%, and the satisfaction of the hospital environment was 92.3%. The two-factor logistic analysis showed that the degree of culture, the history of previous surgery, and the degree of day-to-day operation had an effect on the patient's satisfaction (p0.05). In the degree of culture, there were significant differences between the patients with the junior college/ undergraduate degree as the reference classification, the secondary school/ high school or the middle school and the following culture degree. The OR value was 3.771, 2.546 and 95% CI (1.513, 9.400) respectively (1.513, 9.400), (1.095, 5.919), indicating that the patients with high degree of culture had a low degree of satisfaction with the day operation; Patients with a prior history of surgery had a significant difference in satisfaction with those with no prior history of surgery, or a value of 4.763,95% ci (1.729, 13.122), and a patient satisfaction with a prior history of surgery was 4.763 times that of the patient with no prior history of surgery; Post-operative patients had a significant difference in the degree of day-to-day operation and patient satisfaction, or a value of 0.411,95% ci (0.200, 0.845), indicating that patients with less understanding of day-to-day procedures were more satisfied with post-operative patients who had a better understanding of day-to-day surgery. Conclusion:1. The overall satisfaction of cataract in a hospital in a hospital in Shanxi was 91.2%. In the six-dimensional satisfaction evaluation, the patient satisfaction with the medical procedure and the medical expense is relatively low. The effect of different sex, occupation, average monthly income and the form of medical insurance on the patient's awareness of the patient during the day of cataract surgery was affected by the different degree of culture, the history of prior operation and the degree of understanding of the degree of understanding of the day-to-day operation after the operation. It is suggested that the hospital should increase the daily operation publicity, increase the awareness of the public, reduce the medical expenses through various channels, improve the medical insurance policy, optimize the medical service process and change the medical management mode, and provide the personalized service for patients with different characteristics and improve the patient's satisfaction.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R779.66
本文編號：2484035
[Abstract]:Objective: To study the status of the patient's satisfaction, to analyze the influencing factors of the satisfaction degree, to find the weak link in the medical service process, and to put forward concrete improvement measures to improve the patient's medical experience through the investigation of the patients in a hospital in a hospital in Shanxi province. To improve the patient's satisfaction, explore the process and management mode suitable for the day operation in the hospital, and promote the continuous development of the day operation. Methods: From July to December,2016, a group of 536 patients who were admitted to a hospital in Shanxi province were reviewed, and 536 patients were eligible to receive the questionnaire. The effective rate was 52.4% and the effective rate was 97.8%. The demographic and social characteristics, day-to-day and day-to-day operation of patients with cataract surgery were investigated by questionnaire. Statistical analysis, statistical description, chi-square test and multi-factor logistic regression were used to analyze the status of the patient's satisfaction and the influencing factors, and the level of the test was 0.05. Results:1. The demographic and social characteristics of the patients with cataract surgery showed that in this survey, there were 214 males and 310 females, with a minimum age of 30 and a maximum of 88 years, with an average age of 70.1 to 11.5 years. The results of the study of day-to-day operation showed that: (1) After X-2 test, the rate of postoperative day-to-day operation was higher than that before treatment (X ~ 2 = 135.666, P 0.001). (2) To know the way of day-to-day operation was the first three: the doctor's introduction (71.0%), the relatives and relatives (20.0%), and the post-operative reexamination patients (6.1%). (3) The main reason for choosing daytime operation was the first three: to shorten the waiting time of the hospital and the treatment time (31.5%), to be able to go home earlier and to be less affected by the life of the family and the family (18.3%), and the doctor recommended (17.6%). (4) In the X ~ (2) test, the patients with different sex have different knowledge of the daytime operation, the male is higher than that of the female, the difference is of statistical significance (X _ (sex) ~ 2 = 10.555, p = 0.001), and the overall distribution of the patients with different occupational cataract is different from that of the daytime operation. The knowledge of the retired personnel is the highest, the difference is of statistical significance (X _ (occupation) ~ 2 = 19.806, p = 0.003); the average distribution of the average monthly income of the cataract patients is different from that of the daytime operation, and with the increase of the increase of income, The difference is of statistical significance (X _ (average monthly income) ~ 2 = 14.069, p = 0.001); the average distribution of the knowledge of the patients with cataract in different medical insurance forms is different from that of daytime operation, and the knowledge of the patients participating in the medical insurance for urban workers is the highest. The difference was statistically significant (X _ (medical insurance form) ~ 2 = 14.140, p = 0.003). The results of the patient's satisfaction survey showed that the overall satisfaction of the patients was 91.2%. The satisfaction of the medical treatment process was 88.9%, the satisfaction of the medical quality was 98.8%, the satisfaction of the doctor-patient communication was 92.9%, the satisfaction of the medical ethics was 97.5%, the satisfaction of the medical expenses was 76.7%, and the satisfaction of the hospital environment was 92.3%. The two-factor logistic analysis showed that the degree of culture, the history of previous surgery, and the degree of day-to-day operation had an effect on the patient's satisfaction (p0.05). In the degree of culture, there were significant differences between the patients with the junior college/ undergraduate degree as the reference classification, the secondary school/ high school or the middle school and the following culture degree. The OR value was 3.771, 2.546 and 95% CI (1.513, 9.400) respectively (1.513, 9.400), (1.095, 5.919), indicating that the patients with high degree of culture had a low degree of satisfaction with the day operation; Patients with a prior history of surgery had a significant difference in satisfaction with those with no prior history of surgery, or a value of 4.763,95% ci (1.729, 13.122), and a patient satisfaction with a prior history of surgery was 4.763 times that of the patient with no prior history of surgery; Post-operative patients had a significant difference in the degree of day-to-day operation and patient satisfaction, or a value of 0.411,95% ci (0.200, 0.845), indicating that patients with less understanding of day-to-day procedures were more satisfied with post-operative patients who had a better understanding of day-to-day surgery. Conclusion:1. The overall satisfaction of cataract in a hospital in a hospital in Shanxi was 91.2%. In the six-dimensional satisfaction evaluation, the patient satisfaction with the medical procedure and the medical expense is relatively low. The effect of different sex, occupation, average monthly income and the form of medical insurance on the patient's awareness of the patient during the day of cataract surgery was affected by the different degree of culture, the history of prior operation and the degree of understanding of the degree of understanding of the day-to-day operation after the operation. It is suggested that the hospital should increase the daily operation publicity, increase the awareness of the public, reduce the medical expenses through various channels, improve the medical insurance policy, optimize the medical service process and change the medical management mode, and provide the personalized service for patients with different characteristics and improve the patient's satisfaction.
【學位授予單位】：山西醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R779.66
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