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论文编号：	13529
作者编号：	2320180357
上传时间：	2022/12/4 10:25:00
中文题目：	Z医院住院患者满意度的影响因素及提升策略研究
英文题目：	Research on the factors influencing inpatient satisfaction in Z Hospital and improvement strategies
指导老师：	梁峰
中文关键字：	患者满意度；KANO模型；医院服务质量
英文关键字：	Patient satisfaction; The KANO model; Hospital service quality
中文摘要：	在当前的社会环境下，医患关系长期处于“亚健康”状态。随着科技的不断发展和信息技术的不断提升，出现了以互联网为载体和技术手段的信息咨询、在线预约、在线诊疗、远程会诊、电子处方、医药电商、网络购药、信息记录等多种形式的健康医疗服务。然而有数据显示，互联网医疗存在沟通不顺畅、确诊率低、线上开方难、医疗监管缺位、患者满意度低等问题。这些新的变化均反映出患者满意度的影响因素十分复杂，而医院在未来的医疗服务中面临着许多未知的困难和调整，这就要求医疗机构要高度重视患者满意度测评，不断规范自身服务、提高医疗技术水平，确保患者就医的获得感。然而当前有关于患者满意度的研究主要集中于患者满意度测评及其影响因素的分析，对于患者需求属性研究较少。 本研究以某三级公立肿瘤专科医院为例，对住院患者开展满意度调查，结合当今国内外医学相关基础研究及理论，采用KANO模型技术和其他相关临床统计学方法，研究在新医改和互联网医疗背景下住院患者满意度的现状和存在的问题。通过识别期待属性的服务项目以提出改进策略，针对魅力属性的服务项目提出优化方向，从而为进一步提高医院住院的整体服务水平，构建和谐医患关系出谋划策。 调查结果显示，在各项满意度评分中，医生的诊疗技术、愿意向他人推荐、医生服务态度、医生的沟通情况、护理技术水平是满意度最高的前五项。满意度较低的五项分别是餐饮服务、费用、就诊检查等待时间、焦虑抑郁评估、新医改政策。人口学因素影响结果显示，性别、年龄、文化程度、家庭住址以及住院次数对于患者满意度没有显著性的影响，而不同职业、不同的医疗支付方式对患者满意度影响具有统计学意义。KANO模型分析结果显示，在22个服务项目中，期待属性的项目有14个，分别是病房环境、仪器设备、医生的诊疗技术、医生的沟通情况、医疗决策的参与程度、护理技术水平、指示牌、整体的卫生环境、护工/保洁员的服务、餐饮服务、住院费用的公开透明程度、疼痛管理、医生的服务态度、护士的服务态度。魅力属性影响因素共有5个，分别为院内及院外的会诊制度、体检服务、互联网医院平台服务、新医改政策、医院的随访制度。 综合上述调查结果，本文针对14项期望属性的服务项目提出针对性的改进措施，针对5个魅力属性的服务项目提出未来的优化方向。通过加强完善保障措施，稳步提升期待属性项目的服务质量，使患者满意度得到稳步提升，通过重点改善魅力属性项目质量，提升和打造医院核心竞争力，为医院增强竞争优势提供科学依据。
英文摘要：	In the current social environment, the doctor-patient relationship has been in the state of "sub-health" for a long time. With the continuous development of science and technology and the continuous improvement of information technology, the Internet as the carrier and technical means of information consultation, online appointment, online diagnosis and treatment, remote consultation, electronic prescription, medical e-commerce, online drug purchase, information recording and other forms of health and medical services. However, data show that Internet medical treatment has problems such as poor communication, low diagnosis rate, difficult online prescription, lack of medical supervision, and low patient satisfaction. These new changes are reflected the influence factors of patient satisfaction is complex, the hospital medical service in the future is faced with many unknown difficulties and adjustment, which requires more attention must be paid to the medical institutions and patients' satisfaction evaluation, improving its service level, medical technology, to ensure that patients hospitalized for feeling. However, the current research on patient satisfaction mainly focuses on the evaluation of patient satisfaction and the analysis of its influencing factors, and there is a lack of research on the attributes of patient needs. This study takes a tertiary public cancer hospital as an example to investigate the satisfaction of inpatients. Combining current domestic and international medical related basic research and theory, KANO model technology and other relevant clinical statistics methods are used to study the status quo and existing problems of inpatient satisfaction under the background of new medical reform and Internet medicine. By identifying the service items with expected attributes, we propose safeguard measures, and propose improvement strategies for the service items with attractive attributes, so as to provide suggestions for further improving the overall service level of the hospital and building a harmonious doctor-patient relationship. The results of the survey showed that among the scores of satisfaction, doctors' diagnosis and treatment skills, willingness to recommend to others, doctors' service attitude, doctors' communication, and nursing skills were the top five items of satisfaction. The five items with low satisfaction were catering service, cost, waiting time for medical examination, anxiety and depression assessment, and the new medical reform policy. The results of demographic factors showed that gender, age, education level, home address and hospitalization times had no significant impact on patient satisfaction, while different occupations and different medical payment methods had statistically significant impact on patient satisfaction. The results of KANO model analysis show that 14 out of 22 service items expect features. Ward environment, equipment, technology, communication situation of the doctor, the doctor's diagnosis and treatment of medical decision making participation, nursing technique level, signs, overall health environment, care services, catering services, hospitalization expenses/cleaner degree of transparency, pain management, service attitude of doctors and nurses' service attitude. There are five influencing factors of charm characteristics, which are consultation system in and out of the hospital, physical examination service, Internet hospital platform service, new medical reform policy, and hospital follow-up system. Based on the above survey results, this study proposes targeted improvement measures for 14 expected quality service items, and proposes future optimization directions for 5 service items with attractive attributes. By strengthening and improving the guarantee measures, the service quality of the expected project will be steadily improved, and the patient satisfaction will be steadily improved. By focusing on improving the quality of charm, enhancing and building the core competitiveness of the hospital, it provides a scientific basis for the hospital to build a competitive advantage.
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