Dynamic Analysis Of Inpatient Satisfaction Based On Medical Reform Policy

Objective:To evaluate the achievements and the existing problems of public reform pilot hospital in different periods when the continuous medical reform policies were implemented,we analyzed the changes of the satisfaction of hospitalized patients and the relative medical and nursing indicators in a sample hospital.We hope it would provide the empirical evidence and decision-making reference for the further formulation and improvement in the medical reform policies.Methods:Using the methods of literature analysis and expert consultation.The questionnaire adopts Likert five-grade score method,and carries on questionnaire reliability and validity test.Cluster sampling combined with convenient sampling were used to select 5850hospitalized patients in a Third-class Comprehensive Hospitals from 2015 to 2017 by questionnaires.The data were collected and coded.We input data into EpiData 3.1 by two researchers at the same time,then used SPSS 18.0 to analyze the data,and then used the frequency,percentage,mean,standard deviation,constituent ratio to describe the data.The measurement data were expressed by M±SD,whose comparisons among groups were used t-test or ANOVA.The count data were expressed by rate,whose comparisons were used X~2test Finally,the effects of public hospital reform were evaluated by the analysis of policy research,questionnaires,inductive deductions and other researching methods.Results:After analying the effective 5653 copies of questionnaires on the base of the analysis of medical reform policy,we obtained these following results.1.In the year of 2015,the sample hospital carried out the measures of the National Action Plan for further improvement of medical services,then the average overall satisfaction of the inpatients was 3.90.And in 2016,the policy of"two-controls and four-reforms"was implemented in the public reform-pilot hospital of Hubei Province,the average overall satisfaction was 4.05.While in 2017,for the guideline of"Comprehensive Reform of Urban Public Hospitals",the average overall satisfaction was up to 4.22.2.The average overall satisfaction of inpatients was 4.06 during the three years.And the data showed the average satisfaction score of"quality of service"was the highest(up to4.50),the average score of"technical quality"was 4.48,the scores of patients with"hospitalization process"and"complaint channel"were lower,3.33 and 2.89respectively.The differences in quality of service,technical quality,incorruptible medicine,recommending medical treatment,environmental facilities,hospitalization procedure,complaint channels and overall satisfaction score were significant(P<0.05).3.The age of the patients,marriage,occupation,payment methods were the main factors which influenced the patients'satisfaction scores,and there were no significant differences in the scores of gender,the days of inhospital,hospital expenses on the overall satisfaction.4.The data analysis of nursing related indicators showed the highest score on the nursing responses to the patients,up to an average of 4.52.And on the nursing skills the score was 4.49,and on the protecting patients'privacy was 4.50.In the all,both were to or close to the most satisfactory level(the point=4.50).The survey showed that 89.60%patients highly praised the nursers'skills and supported the nursers.They were generally satisfied to the the nursing attitudes and ethics,and 90%patients were very satisfied to the introduction of the ward environment,however,the 42.20%patients investigated that they were offered little help on humanistic management system in the hospital.The average days of hospitalization,the expenditure proportions of medicine and the medical examinations in medical incomes and the overhead smedical cost of single inpatient all decreased year by year.5.The influencing factors included the hospitalization procedures,the quality of service,the technical quality,the environmental facilities,the incorruptible medicine,the complaint feedback system and the patient recommendations.At the same time,according to the correlation analysis,the indexes of medical reform and nursing services were positively related to the overall satisfaction scores.Among them,the most influential factor was the environmental introduction.The Pearson's correlation coefficient was 0.827.Conclusions:The data from sampling hospital show that,after applying the medical reform policies,the public health service supplier-the national hospitals had made obvious improvements in the inpatient satisfaction scores in 2015-2017.Among the score indexes,the nursing services,incorruptible medicine,environmental facilities,the quality of service and the technical quality showed a steady progress.However,in the areas of the hospitalization procedures and the complaint ways,the national hospitals still need to make their work better.Especially,the food services for inpatients in the national hospitals declined year by year.As an nursing management,they should oversee the achievements and the deficiencies and take some effective measures to afford the better medical services to satisfy the needs of people.