Research On The Multiple Subjects Synergetic Governance Path Of Patient Satisfaction

Objectives: Comprehensive use of frontier theories of expectations,stakeholders,and Synergetic governance,on the basis of clarifying the concept and connotation of patient satisfaction,a combination of qualitative and quantitative methods is used to dig deeper and analyze the interactions between patients,physicians,government,and society,and their potential impact on patient satisfaction.and build a multi subjects influence-participationSynergetic governance path model for patient satisfaction.On the basis of self-developed questionnaires,field surveys were conducted to verify previous research hypotheses and theoretical models to provide strategies and basis for scientific governance and improvement of patient satisfaction.Methods: A total of 15 cities and county level public hospitals in different economic development zones in Zhejiang Province were selected for study.100 inpatients and 50 outpatients were selected for each hospital.1,382 inpatients and 638 outpatients were investigated.Cronbach’s alpha coefficient,confirmatory factor analysis was used to test the reliability and validity of the patient satisfaction scale;median,interquartile range were used to describe satisfaction and satisfaction rate;two samples of Mann-Whitney and multiple samples of Kruskal-were used comparing differences in patient satisfaction with different demographic characteristics;analyze the effect of each subject governance factor on patient satisfaction through multiple linear regression;and use the structural variance model to verify the multi-subjects collaborative governance path model of patient satisfaction.Results:(1)The overall Cronbach’s α coefficients for inpatient and outpatient patient satisfaction scales were 0.954 and 0.934,and the cumulative contribution of the five common factors was 76.25% and 74.54%,both over 60%.(2)Univariate analysis showed that the satisfaction scores of hospitalized patients in urban public hospitals were higher than those of county-level public hospitals and urban medical insurance workers.The personal monthly average income and satisfaction scores showed a “V” trend;retirees,The scores of student-type patients were higher than those of other occupational types(P<0.05);there was no statistical difference in outpatient satisfaction scores of different demographic characteristics.(3)The linear regression shows that the influence of hospital management level on inpatient satisfaction is in turn the service attitude of medical doctors,the medical ethics of medical personnel,the fairness of medical disputes,the convenience of complaints,the responsiveness of complaints,and the referral Convenience(P<0.05);The degree of influence of government governance responsibility fulfillment factors on inpatient satisfaction was,the convenience of the Medicare reimbursement procedure,the supervision of the doctor’s prescriptive behavior,the promotion of the Medicare reimbursement policy,and the medical drug rebate.The supervision and the rationality of the planning and layout of the medical institutions within the jurisdiction(P<0.05);the degree of influence of social governance responsibility fulfillment factors on inpatient satisfaction is in turn the social responsibility awareness of the public media doctor-patient interaction platform and the self-discipline of the medical industry.The role of internal oversight and the public’s initiative in reflecting the opinions and appeals of doctors and patients(P<0.05).The degree of influence of social and medical environmental factors on inpatient satisfaction was in turn the respect of the medical staff and the evaluation of the residents around the hospital.The patient’s evaluation of the medical environment and the patient’s trust in the medical staff(P<0.05).Multi-factor analysis results of outpatients are similar to those of inpatients.(4)The structural equation model shows that the implementation of government governance responsibilities mainly indirectly affects hospital patient satisfaction through hospital management,and the fulfillment of social governance responsibilities through hospital governance responsibilities and hospital management levels indirectly affects inpatient satisfaction.The total effect of potential variables on inpatient satisfaction was,in turn,0.816 for hospital management,0.658 for government governance,0.511 for social governance,and 0.180 for social health.Conclusions:(1)The self-developed patient satisfaction scale has a good reliability and can be used to measure and explain patient satisfaction.(2)There were differences in satisfaction scores among inpatients with different incomes,medical insurance types,and occupational types.(3)Government governance responsibility fulfillment and hospital management level are key governance factors for improving patient satisfaction;patients’ perception of social governance duties is weak,suggesting that we should further mobilize and exert the participation of social forces;reforms and governance on both sides of the supply and demand in the medical field should allow patients to Can be perceived,gained and involved in order to effectively improve patient satisfaction.(4)The government governance responsibilities and social governance responsibilities fulfilled the indirect effects of the mediation variables on patient satisfaction through the level of hospital management.It is the main role and key role of the governance body and meets the patient’s perception of the current situation.(5)Patient satisfaction is influenced and restricted by multiple stakeholders such as patient-medical-government-society,etc.It has the characteristics of multi-sector supervision and governance,and its promotion strategy should adopt collaborative governance.At the supply side,the government’s health care industry leadership,safeguards,supervision,and management responsibilities will be fulfilled.At the demand side,information disclosure will be strengthened,and patient complaints and feedback channels will be improved.The round table governance platform,awareness governance platform,and information disclosure platform will be actively established.Activate the participation of social forces,give play to public opinion supervision and publicity and guidance;strengthen the internal management of hospitals;pay attention to the construction of medical ethics and complaint feedback mechanism;strengthen internal information disclosure in hospitals;Ability to establish rational medical service expectations,improve the patient’s political accomplishments,and perform social responsibilities for participating in social health affairs.