基于因子分析法的我国西部地区县级医院门诊患者就诊满意度研究
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摘要
目的调查我国西部地区县级医院门诊患者满意度,并分析其影响因素。方法采用问卷分析法对我国西部11省县级医院门诊患者满意度进行调查,通过因子分析检验问卷的信度及效度,并通过多因素分析探索不同患者群体的满意度差异。结果因子分析结果显示,问卷总体信度相对较高,患者总体满意度由就医环境与服务水平、就医成本2个维度构成,2 754名受访者总体满意度平均分为3.42;多因素分析结果显示,不同年龄、教育程度、职业、月收入、就诊机构类型及慢性疾病患病情况的受访者的各维度或总体满意度差异有统计学意义。结论我国西部地区县级医院门诊患者总体满意度不高;问卷可行性较好,可作为评价我国经济落后地区门诊医疗服务质量的参考工具。
Objective To investigate the outpatients satisfaction of county-level hospitals in Western China,and to explore the influencing factors.Methods Questionnaire was constructed to survey the satisfaction among randomly selected samples in 11 provinces of Western China.Exploratory factor analysis(EFA)was conducted to study the reliability and validity of questionnaire and multivariate analysis to study the population difference of satisfaction.Results EFA result showed that a 2-factor solution was adopted to explain the overall satisfaction.Factors identified were "hospital environment & service level" and "cost".Overall satisfaction score was 3.42.Multivariate analysis result indicated that population with different age,education background,job,monthly income,visiting hospital category and chronic disease history had significant different dimensional or overall satisfaction.Conclusion The overall satisfaction of county-level hospital outpatients in Western China is relatively low.The validity and reliability of the questionnaire is relatively high,which could be considered as a feasible tool to evaluate the quality of health care service in underdeveloped area.
Objective To investigate the outpatients satisfaction of county-level hospitals in Western China,and to explore the influencing factors.Methods Questionnaire was constructed to survey the satisfaction among randomly selected samples in 11 provinces of Western China.Exploratory factor analysis(EFA)was conducted to study the reliability and validity of questionnaire and multivariate analysis to study the population difference of satisfaction.Results EFA result showed that a 2-factor solution was adopted to explain the overall satisfaction.Factors identified were "hospital environment & service level" and "cost".Overall satisfaction score was 3.42.Multivariate analysis result indicated that population with different age,education background,job,monthly income,visiting hospital category and chronic disease history had significant different dimensional or overall satisfaction.Conclusion The overall satisfaction of county-level hospital outpatients in Western China is relatively low.The validity and reliability of the questionnaire is relatively high,which could be considered as a feasible tool to evaluate the quality of health care service in underdeveloped area.
引文
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[21]国家卫计委统计信息中心.2013第五次国家卫生服务调查分析报告[R].北京:中国协和医科大学出版社,2015.
[22]包曹歆,周莹,李晶,等.2170例门诊患者满意度调查与分析[J].中国医院管理,2015,35(9):34-36.
[23]陈雪玲.欠发达地区农村社区卫生服务中心服务对象满意度调查研究[J].劳动保障世界,2012(20):48-52.
[24]葛智馨,黄葭燕,王淼,等.我国部分农村地区乡镇卫生院门诊患者满意度分析[J].中国卫生事业管理,2011,28(2):132-134.
[25]李健平,李正直,乔慧,等.宁夏县级公立医院综合改革试点医院门诊患者满意度调查[J].宁夏医科大学学报,2016,38(12):1396-1400.
[26]袁叶,李蕾.湖南省某综合医院门诊满意度调查[J].中国卫生产业,2015,12(26):51-53.
[27]周占伟,梅翠竹,张玉媛,等.某三级综合医院门诊患者满意度调查研究[J].现代预防医学,2011,38(7):1262-1265.
[28]江丽丽,郭歌,孔桂兰,等.基于因子分析法和证据推理法的住院患者满意度综合评估[J].解放军医院管理杂志,2016,23(2):101-104.
[29]石景芬,龚永,李元峰,等.门诊患者满意度测评量表研制及实证研究[J].中国卫生事业管理,2015,32(4):262-267.
[2]Saila T,Mattila E,Kaila M,et al.Measuring patient assessments of the quality of outpatient care:a systematic review[J].J Eval Clin Pract,2008(14):148-154.
[3]Aletras VH,Papadopoulos EA,Niakas DA.Development and preliminary validation of a Greek-language outpatient satisfaction questionnaire with principal components and multi-trait analyses[J].BMC Health Serv Res,2006(6):66.
[4]Garratt AM,Bj?rtnes ?A,Krogstad U,et al.The outpatient experiences questionnaire(OPEQ):data quality,reliability,and validity in patients attending52 Norwegian hospitals[J].Qual Saf Health Care,2005,14(6):433-437.
[5]Kleefstra S,Kool R,Zandbelt L,et al.An instrument assessing patient satisfaction with day care in hospitals[J].BMC Health Serv Res,2012(12):125.
[6]Rahmqvist M,Bara AC.Patient characteristics and quality dimensions related to patient satisfaction[J].Intern J Qual Health Care,2010(22):86-92.
[7]Wei J,Shen L,Yang HB,et al.Development and validation of a Chinese outpatient satisfaction questionnaire:evidence from 46public general hospitals and5151outpatients[J].Public Health,2015,129(11):1523-1529.
[8]Mansour M.Factor analysis of nursing students'perception of patient safety education[J].Nurse Educ Today,2015,35(1):32-37.
[9]Smith RJ,Lehning AJ,Dunkle RE.Conceptualizing agefriendly community characteristics in a sample of urban elders:an exploratory factor analysis[J].J Gerontol Soc Work,2013,56(2):90-111.
[10]Likert R.A Technique for the Measurement of Attitudes,Archives of Psychology[M].New York:The Science Press,1932.
[11]Alamanou GD,Balokas AS,Fotos VN,et al.Information needs of cancer patients:Validation of the Greek Cassileth's Information Styles Questionnaire[J].Eur JOncol Nurs,2016(20):49-57.
[12]Field A.Discovering Statistics Using IBM SPSS[M].London:SAGE Publication,2013.
[13]Pallant J.SPSS Survival Manual.A Step by Step Guide to Data Analysis Using SPSS for Windows(4th edition)[M].Buckingham:Open University Press,2010.
[14]吴明隆.问卷统计分析实务---SPSS操作与应用[M].重庆:重庆大学出版社,2010.
[15]Kline P.The Handbook of Psychological Testing(2nd edition)[M].London:Routledge,1999.
[16]Hutcheson GD,Sofroniou N.The Multivariate Social Scientist[M].London:SAGE,1999.
[17]Kaiser HF.The application of electronic computers to factor analysis[J].Educ Psychol Meas,1960,20(1):141-151.
[18]Cattell RB.The scree test for the number of factors[J].Multivariate Behav Res,1966,1(2):245-276.
[19]Horn JL.A rationale and test for the number of factors in factor analysis[J].Psychometrika,1965,30(2):179-185.
[20]Distefano C,Zhu M,Mindrila D.Understanding and using factor scores:considerations for the applied researcher[J].Pract Asse,Res Eval,2009,14(20):115-125.
[21]国家卫计委统计信息中心.2013第五次国家卫生服务调查分析报告[R].北京:中国协和医科大学出版社,2015.
[22]包曹歆,周莹,李晶,等.2170例门诊患者满意度调查与分析[J].中国医院管理,2015,35(9):34-36.
[23]陈雪玲.欠发达地区农村社区卫生服务中心服务对象满意度调查研究[J].劳动保障世界,2012(20):48-52.
[24]葛智馨,黄葭燕,王淼,等.我国部分农村地区乡镇卫生院门诊患者满意度分析[J].中国卫生事业管理,2011,28(2):132-134.
[25]李健平,李正直,乔慧,等.宁夏县级公立医院综合改革试点医院门诊患者满意度调查[J].宁夏医科大学学报,2016,38(12):1396-1400.
[26]袁叶,李蕾.湖南省某综合医院门诊满意度调查[J].中国卫生产业,2015,12(26):51-53.
[27]周占伟,梅翠竹,张玉媛,等.某三级综合医院门诊患者满意度调查研究[J].现代预防医学,2011,38(7):1262-1265.
[28]江丽丽,郭歌,孔桂兰,等.基于因子分析法和证据推理法的住院患者满意度综合评估[J].解放军医院管理杂志,2016,23(2):101-104.
[29]石景芬,龚永,李元峰,等.门诊患者满意度测评量表研制及实证研究[J].中国卫生事业管理,2015,32(4):262-267.