社区老年病人怎样评价社区卫生服务的质量

How Senior Patients Evaluate the Quality of Community Health Services in China

目的通过分析老年病人在接受社区卫生服务过程中的体验信息,探讨老年病人对社区卫生服务质量的认识,以促进社区卫生服务质量的持续改善。方法选择北京市某社区病人体验和满意度监测中的700例病人,≥65岁的老年人206人(老年组),<65岁者494人(非老年组)。结果63.0%的老年病人对社区卫生服务"比较满意"、"很满意"和"非常满意",53.5%的老年病人认为社区卫生服务机构提供了"一些"、"不少"和"非常多的帮助"。在42个质量监测项目中,老年组病人对其中12个项目的评价结果与非老年组病人间差异有显著性意义(P<0.05)。老年病人认为社区卫生服务的质量优势主要体现在医生服务方面,包括技术服务质量和人际服务质量。他们认为社区卫生服务的可及性、病人意见和投诉管理、安排复查和转诊、隐私保护等方面的服务质量需要进一步提高。结论通过掌握老年病人对社区卫生服务的看法和质量评价,可以掌握老龄化社区的社区卫生服务需要,并以此为依据促进以社区为基础的健康老龄化以及和谐的社区卫生服务发展。

Objective To explore the experiences and opinions of senior patients attending community health services and general practitioners,through general practice quality monitoring.Methods 207 patients aged 65 and over were surveyed using a self-completion questionnaire.Results 63% of senior patients rated community health services as fair,very good or excellent;while 53.5% of them believed community health provided somewhat,quite a bit or a great deal of help.Within the 42 quality monitoring items,12 items were rated differently by senior patients compared with other patients aged less than 65 years old.According to senior patients,the most significant positive feature that encouraged them to use community health services was the quality of doctor services,including technical skills and inter-personal manner.However,weaknesses in quality management were also highlighted by the seniors.Patients argued they had difficulty accessing appointments,and the appointment times were often not suitable.Seniors also pointed out problems with the facilities for old patients and children,which are barriers to gaining access to community health care.Senior patients suggested that complaint management was weak.Patients were not well informed about how to lodge complaints,and even when they had contact with complaint managers,they were dissatisfied with the feedback.Senior patients reported that referral and follow up services were not provided as expected.In addition,they believed privacy protection should be greatly improved.Conclusion Quality information provided by this study is more specific and valuable then in previous patient studies in China.For quality managers of community health services,especially those providing services to a highly aged population,the voice of senior patients is a critical source of information to assist local government and providers to formulate community health and general practice planning,improve quality of services for people,and promote healthy and a harmonised ageing community and people centered health system.The information from quality evaluation studies should be used by healthcare managers to encourage continuing quality of care improvement that contributes to community based healthy and successful ageing.