The Impact Of Non-technical Factors On The Quality Of Medical Services Assessment

With the country’s deepening medical and health care reform, it has been the foundation and core work of medical management facilities to improve the quality of medical services and raise the degree of patient satisfaction. Among various factors affecting the quality of medical services, the non-technical factors have also started to play an increasingly important role, but this has only been seldomly reported. The aim of this study is to investigate the patient satisfaction assessment on non-technical service quality from the patient’s perspective and explore the current situation and the reasons for non-technical factors to affect the quality of medical services, and to make advisory suggestions for hospital administrators and medical staff.In this study, literature analysis and Delphi expert evaluation method were adopted to evaluate non-technical factors. We used stratified random sampling to survey a total of over 1,000 paitents, either hospitalized or those seeking emergency care, in one third-level hospitals, two second-level hospitals and five community health service centers in Putuo District using a standardized questionnaire. The survey included 3 level-one indicators: health care environment, medical services and medical ethics; 6 level-two indicators: hospital environment, treatment processes, service attitude, effective communication, right ensuring and emotional interaction; 22 level-three indicators such as infrastructure facilities, convenient medical service and privacy protection; and 35 specific indicators such as hospital parking convenience, outpatient appointment service for expert doctors that evaluating the overall degree of patient satisfaction. Alpha reliability coefficient method and factor analysis were used to assess the reliability and validity of the questionnaire, logistic regression analysis, t test and one-way ANOVA were used to evaluate patient satisfaction scores for further statistical analysis.Results of the survey showed a positive correlation between patients’ evalution for non- technical factors and overall evaluation of medical service qualities; Patient satisfaction scores for level-one non-technical factors(from low to high) were: medical environment, medical services and medical ethics, satisfaction scores on level-two indicators(from low to high) were: treatment process, hospital environment, effective communication, attitude of service, right ensuring and emotional interaction(No statistically significant difference was found among items of attitude of service, right ensuring and emotional interaction); In addition, patient satisfaction scores of level-three hospitals were less than those of level-one and two hospitals; meanwhile, satisfaction scores of outpatient and emergency department patients were lower than those of hospitalized patients; Patient evaluation for non- technical service differed accoding to their distinct demographic factors: Younger, higher educated and student populations rated lower for satisfaction. No significant difference was found in patient satisfaction between male and female patients.Our suggestions based on the findings is that more emphasis should be put on non-technical factors affecting the quality of medical services. Measurements such as the establishment of the safeguard mechanism, incentive and restraint mechanisms, and monitoring mechanisms and training mechanisms should be taken to build the foundation of quality improvement of medical services; More efforts should be made to optimize outpatient services through better allocated medical resources, better informationization construction, reasonable arrangements of human resources, and more attention payed to details, in order to improve patient experience of their hospital visit; Other initiatives, such as public hospital reforms, promoting the work of medical associations, fully opening of multi-site practicing for physicians, improving the medical insurance payment system, implementation of the graded diagnosis and treatment system, and rational allocation of medical resources, should be considered; Tailored service should be provided to meet the needs of different populations groups, with particular respect for the distinct cultural habits privacy of the patients, and respect their right to get informed consent. Continuous attentions should be paid to improve patient satisfaction evaluation of the quality of medical services.