上海交通大学学报（医学版）

上海交通大学学报（医学版） ›› 2013, Vol. 33 ›› Issue (6): 729-.doi: 10.3969/j.issn.1674-8115.2013.06.006

• 专题报道（卫生系统研究） • 上一篇    下一篇

北京市改革试点公立医院住院患者满意度调查

袁素维1，高 星2，刘雯薇3，杨小冉2，陶婧婧1，李志建3，曹剑涛3，张 哲1，陆 琳1，马 进1   

  1. 1.上海交通大学 公共卫生学院， 上海 200025； 2.北京市卫生局医改办， 北京 100053； 3.上海交通大学 安泰经济与管理学院， 上海 200030
  • 出版日期:2013-06-28 发布日期:2013-06-28
  • 通讯作者: 马进, 电子信箱: majin@shsmu.edu.cn。
  • 作者简介:袁素维（1989—）， 女， 硕士生; 电子信箱: yuansuwei@126.com。
  • 基金资助:

    国家卫生部基金（2012YG06）和上海市公共卫生重点学科建设项目（12GWZX0601）

Survey on satisfaction of inpatients in pilot public hospital of reform in Beijing

YUAN Su-wei1, GAO Xing2, LIU Wen-wei3, YANG Xiao-ran2, TAO Jing-jing1, LI Zhi-jian3, CAO Jian-tao3, ZHANG Zhe1, LU Lin1, MA Jin1   

  1. 1.School of Public Health, Shanghai Jiaotong University, Shanghai 200025, China; 2.Department of Health System Reform, Beijing Municipal Health Bureau, Beijing 100053, China; 3.Antai School of Economics and Management, Shanghai Jiaotong University, Shanghai 200030, China
  • Online:2013-06-28 Published:2013-06-28
  • Supported by:

    Foundation of the Ministry of Health of China, 2012YG06; Shanghai Public Health Key Discipline Construction Project, 12GWZX0601

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摘要：

目的 从患者角度评价北京市公立医院的改革效果。方法 在北京市1所改革试点医院（实行了总额预付试点和疾病诊断相关分组付费试点两项改革）和1所非试点医院（未实行付费机制改革）中各选取200名住院患者，采用《试点城市公立医院住院患者满意度调查表》调查患者对各项改革措施的满意度。结果 两所医院住院患者的人口学特征比较差异无统计学意义（P>0.05）。试点医院的总体满意度得分显著高于非试点医院[（4.64±0.24）分和（4.40±0.28）分，P<0.01]。在5项一级指标中，“住院环境”“医疗服务提供”和“医疗辅助服务”3项指标的满意度得分均显著高于非试点医院（P<0.01）；试点医院和非试点医院的总体满意率分别为93.18%和90.98%，差异无统计学意义（P>0.05）；其中“医疗服务提供”的满意率最低（84.00%和79.58%，P>0.05），试点医院的“医疗辅助服务”满意率显著高于非试点医院（97.04%和87.83%，P<0.01）。在20项二级指标中，除“入院等待时间”“入院手续办理”“医师对住院原因的解释”“检查人员的态度”和“医师对患者需求的反应”5项指标的满意度得分比较差异无统计学意义（P>0.05）外，其他15项指标试点医院的满意度得分均显著高于非试点医院（P<0.01），其中患者对“主管护士态度”的满意度最高，“住院费用”满意度最低。与总体满意度强相关的二级指标包括“费用查询便捷度”“住院环境满意度”和“医院伙食质量”。结论 试点医院住院患者的总体满意度高。北京市需重点推进以总额预付和疾病诊断相关分组为主的付费机制改革，重点控制医药费用，提高住院患者的满意度。

关键词: 公立医院改革, 住院患者, 满意度, 问卷调查

Abstract:

Objective To evaluate the effectiveness of reform on public hospital in Beijing by inpatients. Methods Two hundred inpatients were selected from one pilot hospital of reform (with global budget and diagnosis related groups payment reform) and non-pilot hospital (without payment reform) respectively, and the satisfaction of inpatients with reform measures was surveyed with questionnaires. Results There was no significant difference in demographic characteristics between two hospitals (P>0.05). The total score of satisfaction of pilot hospital (4.64±0.24) was significantly higher than that of non-pilot hospital (4.40±0.28)(P<0.01). Among 5 first-level indicators, the scores of hospital environment, health service providing and medical auxiliary service in polit hospital were significantly higher than those in non-pilot hospital (P<0.01). There was no significant difference in the satisfaction rate between pilot hospital (93.18%) and non-pilot hospital (90.98%)(P>0.05). The satisfaction rate of health service providing was the lowest among 5 indicators in these two hospitals, and were 84.00% and 79.58% respectively (P>0.05). The satisfaction rate of medical auxiliary service in pilot hospital (97.04%) was significantly higher than that in non-pilot hospital (87.83%)(P<0.01). Among 20 second-level indicators, except for the indicators of waiting time for admission, admission procedures, explanation of admission reason by doctor, attitude of medical technician and doctor's response to the demand of patients, the scores of satisfaction of the other 15 indicators in pilot hospital were significantly higher than those in non-pilot hospital (P<0.01). Moreover, inpatients were most satisfied with the service attitude of nurses, and were most dissatisfied with the health care cost. Convenience of bill query, satisfaction of hospital environment and food quality of hospital were second-level indicators that significantly correlated with the total satisfaction score of inpatients. Conclusion The satisfaction of inpatients in pilot hospital is relatively higher. Further efforts should be made to push forward global budget and diagnosis related groups payment reform in Beijing in order to control the medical expenditure and improve the satisfaction of inpatients.

Key words: public hospital reform, inpatients, satisfaction, questionnaire survey