县乡两级住院满意度及影响因素分析

目的 通过比较分析县乡两级农村住院患者满意度及其影响因素的相关性，寻找县乡两级医疗机构提高服务满意度的着力点。方法 采用整群随机抽样的方法，从山东省曲阜、沂源和莒县3个县抽取县级医院住院患者486例、乡镇卫生院住院患者421例进行住院服务满意度问卷调查。结果 县、乡级医疗机构住院患者总体满意度得分分别为（3.37±0.70）、（3.18±0.65）分，县级高于乡镇级，差异有统计学意义（P<0.01）；县级医疗机构住院患者对基本环境、服务流程、治疗效果的满意度得分分别为（3.69±0.68）、（3.81±0.61）、（3.75±0.62）分，均高于乡镇级的（3.41±0.61）、（3.47±0.60）、（3.57±0.60）分，差异均有统计学意义（P<0.01）；乡镇卫生院住院患者仅在医药费用上的满意度[（3.92±0.60）分]高于县级[（3.19±0.70）分]，差异有统计学意义（P<0.01）；县乡医疗机构在病情解释、服务态度上的评价差异无统计学意义（P>0.05）。年龄、医疗总费用、个人支付金额、住院天数与县乡两级的总体满意度均呈负相关；文化程度、机构能力各因素与县乡两级的总体满意度均呈正相关。结论 加强乡镇卫生院的机构能力建设，降低县级医疗机构的就医费用是当前提高农村住院患者满意度的优先措施。

Hospitalization satisfaction and its influencing factors among rural inpatients in county and township hospitals

Objective To examine hospitalization satisfaction and its related factors among rural inpatients in county and towship hospitals and to provide reference for improving medical service of the hospitals.Methods Totally 486 patients from county hospitals and 421 from township hospitals were selected with stratified cluster random sampling to conduct a hospitalization satisfaction survey in Ju county,Yiyuan county and Qufu county in Shandong province.Results The overall satisfaction to medical service of township hospitals and county hospitals were 3.37±0.70 and 3.18±0.65,and the overall satisfaction to township hospitals was lower than to county hospitals(P<0.01).The township hospitals also had lower scores than the county hospitals in the inpatients satisfaction to environment(3.41±0.61 vs 3.69±0.68),service process(3.47±0.60 vs 3.81±0.61),and treatment outcome(3.57±0.60 vs 3.75±0.62)(P<0.01 for all).However,the township hospitals had higher scores than the county hospitals in the inpatients' satisfaction to medical expenses(3.92±0.60 vs 3.19±0.70)(P<0.01).There were no significant differences in the inpatients satisfaction to disease explaination,service attitude between county and township hospitals.Age,total expense,amount of personalpayment,length of stay were negatively correlated with inpatients' overall satisfaction for both county and township hospitals.However,educational achievement,per capita family income,and the institutional capacity were positively correlated with the inpationts' overall satisfaction for hospitals at both county and township levels.Conclusion Strengthening the township hospitals' capacity building and reducing the medical costs of inpatients of county hospitals are the priority measures to improve the rural inpatients' hospitalization satisfaction.