Comparison of patients' preferences and evaluations regarding aspects of general practice care
作者:H. Jung、M Wensing、A de Wilt、F Olesen、R Grol
DOI:10.1093/fampra/17.3.236
日期:2000.6.1
Background. Although patients' views on health care are perceived to be crucial, insight into the different constructs capturing these views remains limited.Objective. The aim of this study was to determine the relationship between patients' preferences and their evaluations of general practice care.Methods. Patients visiting five rural practices in The Netherlands were asked to complete a questionnaire measuring either their evaluations or their preferences on 44 aspects of general practice care. After at least 3 weeks, those patients who had answered the evaluation questionnaire received the questionnaire measuring their preferences, and vice versa.Results. A total of 449 patients answered both questionnaires (response 70%). The longer the period after the consultation, the lower was the mean percentage of all 44 aspects rated as ‘good’ in the evaluation questionnaire (P = 0.006) and the higher was the mean percentage of all 44 aspects rated as ‘very important’ in the preference questionnaire (P = 0.046). The Spearman rank order correlation between the ranking of patients' evaluations and patients' preferences was 0.34, a low although significant correlation (P = 0.024), i.e. the two rank orders do not resemble each other very much.Conclusions. Patients clearly distinguished their preferences from their evaluations of general practice care. Aspects of general practice care, whether important or not, can be evaluated positively or negatively. Patients' preferences and patients' evaluations are, however, both influenced by the length of the time elapsed since the consultation.
背景。尽管患者对医疗保健的看法被认为至关重要,但对反映这些看法的不同结构的了解仍然有限。本研究旨在确定患者的偏好与他们对全科医疗服务的评价之间的关系。访问荷兰五个乡村诊所的患者被要求填写一份问卷,调查他们对全科医疗服务 44 个方面的评价或偏好。至少 3 周后,回答过评价问卷的患者会收到调查其偏好的问卷,反之亦然。共有 449 名患者回答了这两份问卷(回复率为 70%)。就诊时间越长,在评估问卷中被评为 "良好 "的 44 个方面的平均百分比越低(P = 0.006),而在偏好问卷中被评为 "非常重要 "的 44 个方面的平均百分比越高(P = 0.046)。患者评价与患者偏好之间的斯皮尔曼等级排序相关性为 0.34,相关性虽低但显著(P = 0.024),即两种等级排序不太相似。患者对全科医疗服务的偏好与评价明显不同。全科医疗服务的各个方面,无论重要与否,都可以得到积极或消极的评价。然而,患者的偏好和评价都会受到就诊时间长短的影响。