定点医院模式下结核病患者满意度研究

中国防痨杂志 ›› 2013, Vol. 35 ›› Issue (10): 773-777.

定点医院模式下结核病患者满意度研究

谢海波陈森刘莹娟刘小秋李峻姜世闻张慧王黎霞詹思延

100191 北京大学公共卫生学院流行病与卫生统计学系（谢海波、陈森、詹思延），毒理学系（刘莹娟）；中国疾病预防控制中心结核病预防控制中心（刘小秋、李峻、姜世闻、张慧、王黎霞）

收稿日期:2013-07-17 出版日期:2013-10-10 发布日期:2014-01-03
通信作者: 詹思延 E-mail:siyan-zhan@bjmu.edu.cn

Satisfaction degree of tuberculosis patients on designated hospitals

XIE Hai-bo, CHEN Sen, LIU Ying-juan, LIU Xiao-qiu, LI Jun, JIANG Shi-wen, ZHANG Hui, WANG Li-xia, ZHAN Si-yan

Department of Epidemiology & Biostatistics, School of Public Health, Peking University, Beijing 100191, China

Received:2013-07-17 Online:2013-10-10 Published:2014-01-03
Contact: ZHAN Si-yan E-mail:siyan-zhan@bjmu.edu.cn

摘要/Abstract

摘要： 目的了解定点医院防治模式下结核病患者的满意度，并为定点医院防治模式的改进提供依据。方法选取全球基金结核病项目2009年10月启动定点医院模式的40个县(区)级定点医院作为研究现场，通过病案查询了解诊疗信息，通过问卷调查了解患者满意度情况。共发放问卷907份，最终收回有效问卷795份，问卷有效率为99.38%。采用卡方检验的统计分析方法，比较不同类型患者的满意度，P＜0.05为差异有统计学意义。结果 94.65%（752/795）的患者愿意推荐患结核病的亲友到定点医院就诊，患者对定点医院各方面满意度从高到低依次是医疗技术（86.79%，690/795）、服务态度（86.79%，690/795）、健康宣传教育（简称“宣教”）（83.02%，660/795）、就诊流程（76.60%，609/795）、门诊环境（73.84%，587/795）、宣教效果（73.21%，582/795）和费用承担（41.89%，333/795）。涂阳患者在医疗技术、宣教效果、费用负担方面的满意度（82.76%，264/319；69.59%，222/319；36.99%，118/319）均低于涂阴患者的满意度（89.43%，423/473；75.90%，359/473；45.45%，215/473）（χ²值分别为7.371、4.673、5.436，P值均＜0.05）。服药时有人督导的患者对健康宣教的满意度（84.16%，558/663）高于无人督导的患者（75.76%，100/132）（χ²=4.195，P＜0.05）。服药时有人督导的患者能承担费用的比例（39.06%，259/663）低于无人督导的患者（55.30%，73/132）（χ²=12.944，P＜0.001）。结论结核病患者对定点医院模式总体比较认可，但定点医院仍需改进门诊环境和就诊流程，落实结核病诊治优惠政策，进一步提高患者的满意度。

关键词: 结核, 肺, 医师诊疗模式, 病人满意度, 医院, 专科

Abstract: Objective To understand the satisfaction degree of tuberculosis (TB) patients on designated hospitals, and to provide reference for designated hospital model improvement. Methods Forty designated hospitals in which designated hospital model launched in October 2009 in Global Fund TB program area were enrolled in this study. 907 questionnaires were sent to TB patients and 795 effective questionnaires were retrieved, and the effective rate of questionnaire was 99.38%. TB patients’ information of diagnosis and treatment were attained through medical record and satisfaction degree on designated hospitals through questionnaires. The satisfaction degree of different types of patients was compared by chi-square test, 0.05 was set as the criteria of statistically significant difference. Results Of 795 TB patients, 94.65% (752/795) of the patients wanted to recommend designated hospital to their relatives with TB. The diminishing sequence of satisfaction degree on all aspects of designated hospitals was medical technology (86.79%, 690/795), service attitude (86.79%, 690/795), health promotion (83.02%, 660/795), treatment process (76.60%, 609/795), outpatient environment (73.84%, 587/795), effect of health promotion (73.21%, 582/795) and expenses (41.89%, 333/795). The satisfaction degree of sputum smear positive TB patients on medical technology, effect of health promotion and expenses (82.76%, 264/319; 69.59%, 222/319; 36.99%, 118/319) were all lower than those of sputum smear negative TB patients (89.43%, 423/473; 75.90%, 359/473; 45.45%, 215/473) (χ² values were 7.371, 4.673 and 5.436 respectively, and all P values were lower than 0.05). TB patients supervised taking medicine had higher satisfaction degree on health promotion (84.16%, 558/663) than those without supervision (75.76%, 100/132) (χ²=4.195, P<0.05). The proportion of affordable expenses of TB patients supervised taking medicine (39.06%, 259/663) was lower than those without supervision (55.30%, 73/132) (χ²=12.944, P<0.001). Conclusion Although the designated hospital model obtains the approval of most of TB patients, it still needs to improve the outpatient environment and treatment process, and to carry out the free diagnosis and treatment policy for TB patients, in order to further improve the TB patients’ satisfaction.

Key words: Tuberculosis, pulmonary, Physician&, rsquo, s practice patterns, Patient satisfaction, Hospitals, special

谢海波陈森刘莹娟刘小秋李峻姜世闻张慧王黎霞詹思延. 定点医院模式下结核病患者满意度研究[J]. 中国防痨杂志, 2013, 35(10): 773-777.

XIE Hai-bo, CHEN Sen, LIU Ying-juan, LIU Xiao-qiu, LI Jun, JIANG Shi-wen, ZHANG Hui, WANG Li-xia, ZHAN Si-yan. Satisfaction degree of tuberculosis patients on designated hospitals[J]. Chinese Journal of Antituberculosis, 2013, 35(10): 773-777.

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