A Study On The Satisfaction Of Outpatients And Inpatients On Medical Service After The New Medical Reform In A Third-grade Hospital In Shenyang

Objective: China's medical reform has been implementing the concept of "patient-centered",to provide patients with more convenient quality medical and health services.Patient's satisfaction is one of the important way to reflect the medical quality.The satisfaction evaluation system can diagnosis of hospital services,help clear the specific problems of the various aspects in hospital to improve the level of medical services.and form the effective improvement measures and suggestions.Propose effective improvement measures and Suggestions Methods: A random sampling method was used to investigate the outpatients and inpatients(hospitalized for more than 5 days)in a class a public hospital in Shenyang from 2017 to 2018.A total of 1170 cases of effective responses were obtained in this study,including 583 outpatients(with answering rate 72%)and 587 inpatients(with answering rate 90%).Combined with literature analysis,qualitative interview results and the current medical situation in China,a measurement scale of outpatient and inpatient satisfaction was developed.The dimensions that need to be evaluated urgently for patient satisfaction are determined as follows: medical level,service attitude,basic hospital conditions,medical treatment process,medical expenses and auxiliary facilities.Factors included demographic information,medical experience,and the rights and obligations of doctors and patients.SPSS20.0 was used for statistical analysis.Cronbach's ? coefficient was used for reliability test.Pearson correlation analysis was used to test the validity of the scale.Exploratory factor analysis was used to test the structural validity of the scale.Student's t test and anova test were used for univariate analysis.The general linear model(GLM)method was used for multifactor analysis.Kappa value and Pearson analysis were used to test the consistency and collinearity among variables.Result: 1.Test of scales: The outpatient and inpatient scales were reasonable;The results of the reliability test showed that the Cronbach's?coefficient of the outpatient and inpatient scales was above 0.9.Each scale has a good validity level.The exploratory factor analysis results showed that 6 main factors could be extracted from the scales including medical level,service attitude,basic hospital conditions,medical treatment process,medical expenses and auxiliary facilities.2.Satisfaction level and distribution:The satisfaction scores of outpatient and inpatient patients reached more than 85% of the total score.3.Influencing factors analysis:(1)demographic characteristics: According tothe analysis results of the generalized linear model,there was a significant correlation between outpatient satisfaction and factors including marital status,education level,family income and occupation(P<0.05).The correlation of family income is strong,its influence is mainly reflected in the satisfaction of medical treatment process and auxiliary facilities.Secondly,the degree of education has a relatively significant influence on the satisfaction level of outpatients,which is mainly reflected in medical care level,service attitude,basic conditions and medical expenses.The analysis results of inpatient satisfaction showed that marital status had a significant effect(P<0.05),which was mainly reflected in medical service attitude.(2)Medical experience.For outpatient satisfaction,whether the first time of patient to seek medical treatment and the awareness of the disease have a significant effect(P<0.05).The awareness of the disease has the largest correlation with outpatient satisfaction,which is mainly reflected in the dimensions of medical care level,service attitude,basic conditions and medical expenses.The results of inpatient satisfaction analysis showed that awareness of the disease had a significant effect,which was mainly reflected in the dimensions of service attitude,medical expenses and auxiliary facilities.(3)Rights and obligations of medical staff and patients.The study found that the rights of medical staff,obligations medical staff,rights of patients and obligations of patients were collinear,and the obligations of medical staff had a more significant effect on patient satisfaction.Conclusion: 1.Both the outpatient satisfaction scale and the inpatient satisfaction scale are reasonable and have good reliability and validity.2.The outpatient and inpatient satisfaction levels of the surveyed population are high in all dimensions and have reached the basic national standards.3.Education level,family income,marital status and occupation have an effect on the satisfaction of outpatients;Marital status had an effect on the satisfaction of inpatients with medical service attitude.Patients with high awareness of the disease had higher satisfaction.4.As the mobile population of the hospital,outpatients have more urgent needs for detailed medical services,so they pay more attention to the obligations of medical staff.Inpatients' awareness of medical staff's obligations mainly affects their satisfaction with the level of medical care and medical service attitude.