中国全科医学2017，Vol.20Issue(6)：699-705,710,8.DOI:10.3969/j.issn.1007-9572.2017.06.013
基于医患双方的公立医院声誉评价指标体系研究
Index Evaluation System of Reputation of Public Hospitals Based on Both Doctors and Patients
摘要
Abstract
Background At present,the evaluation and examination system of public hospitals in China is very imperfect,and the traditional " top - down" style performance appraisal of hospitals has made little success. Objective To construct an index evaluation system of reputation of public hospitals based on both doctors and patients,ease the imbalance of information between doctors and patients and guide the patients to seek medical treatment rationally. Methods Based on extensive literature research and expert consultation methods,the index evaluation system of reputation of public hospitals based on both doctors and patients was developed. It was divided into two parts,including doctors(7 primary indexes and 30 secondary indexes)and patients(5 primary indexes and 16 secondary indexes). The secondary indexes based on the two parts of doctors and patients were transformed into doctors' questionnaire ( including 7 dimensions,30 items) and patients' questionnaire (including 5 dimensions and 16 items)respectively. By cluster random sampling method,doctors and patients from two tertiary hospitals(one hospital of western medicine and one hospital of traditional Chinese medicine)in the southern,central and northern areas of Jiangsu Province were selected to take a questionnaire survey from March to May in 2015. The reliability of the index system was evaluated by descriptive analysis,correlation analysis and significance test of difference in extreme group,and the construct validity of the index system was evaluated by KMO test,Bartlett 's spherical test,principal component analysis and factor maximum rotation. Results A total of 150 questionnaires were distributed to doctors,and 126 valid questionnaires were received with an effective response rate of 84. 0% ;and 210 questionnaires were distributed to patients, and 210 valid questionnaires were received with an effective response rate of 100. 0%. The average number of total score of doctors' questionnaire was 3. 64,the mean score of each item was between 2. 71 and 4. 22,the average standard deviation of each item was 0. 81,and the score of each item had all included 1 to 5 points;while the average number of total score of patients' questionnaire was 3. 47, the mean score of each item was between 2. 57 and 4. 05,the average standard deviation of each item was 0. 84,and the score of each item had all included 1 to 5 points. The ITC between the scores of each indexes and total scores of the questionnaires of doctors and patients were both greater than 0. 400,and the overall Cronbach's α coefficient of the questionnaires of doctors and patients was 0. 950 and 0. 938 respectively. According to the 27% extreme area of total score of doctors and patients,they were respectively divided into high - score group(34 doctors and 57 patients)and low - score group(34 doctors and 57 patients), and the score of each item in questionnaires of both doctors and patients in high - score group was higher than that in low - score group(P ﹤ 0. 05). In doctors' questionnaire,the KMO was 0. 808,Bartlett's spherical test χ2 was 2 920. 623,df was 435, and P ﹤ 0. 001;in patients' questionnaire,the KMO was 0. 930,Bartlett's spherical test χ2 was 1 969. 937,df was 120,and P﹤ 0. 001;both doctors' and patients' questionnaire all meet the requirements of principal component analysis. Conducting the principal component analysis on the doctors' questionnaire,7 common factors were extracted according to the standard of factor eigenvalue greater than or equal to 1. 000,they were respectively named as service quality,innovation ability,technology, personnel quality,public relations,cost and social responsibility,the total contribution rate was 72. 800% and the load values for each item were all greater than 0. 500. The principal component analysis on the patients' questionnaire was conducted,4 common factors were extracted according to the standard of factor eigenvalue greater than or equal to 1. 000,they were named as service quality,cost,technology,and social responsibility respectively,the total contribution rate was 75. 079% and the load values for each item were all greater than 0. 500. Conclusion The index evaluation system of reputation of public hospitals based on both doctors and patients is in good reliability and construct validity,which has certain scientific nature and application value.关键词
医院,市立/医生病人关系/质量指标,卫生保健Key words
Hospitals,municipal/Physician - patient relations/Quality indicators,health care分类
医药卫生引用本文复制引用
杨毅,田侃..基于医患双方的公立医院声誉评价指标体系研究[J].中国全科医学,2017,20(6):699-705,710,8.基金项目
教育部哲学社会科学研究重大课题攻关项目 （）
