农村患者对乡村医生满意度的影响因素研究——基于贵州省六盘水市问卷调查的结构方程分析

Determinants on patient satisfaction to rural doctors: Structural equation analysis of Liupanshui City,Guizhou Province

目的:研究农村患者对乡村医生满意度的影响因素。方法:基于贵州省六盘水市的实地调查数据,采用结构方程模型,从乡村医生的外在形象、服务质量、诊疗质量和和谐医患关系四个维度进行研究。结果:研究发现诊疗质量对农村患者满意度的直接影响最大,其次为服务质量、外在形象和和谐的医患关系,农村患者满意与否对农村患者忠诚度影响比较明显。结论:农村患者对乡村医生的满意度和忠诚度主要基于亲缘和地缘关系,受诊疗技术、诊疗环境、诊疗设备、服务意识等限制,乡村医生的"守门人"角色无法体现,基层卫生体系受到严重的影响。

Objective： To study the determinants that affect patient satisfaction to rural doctors. Methods：Based on survey data of Liupanshui City,Guizhou Province,structural equation modeling analysis was adopted,and the study was mainly from the following four aspects： the image of rural doctors,service quality,quality of diagnosis and treatment,and harmonious doctor-patient relationships. Results： The study found that the quality of diagnosis and treatment had the greatest direct impact on rural patient satisfaction,followed by service quality,the image of rural doctors and harmonious doctor-patient relationships; rural patient satisfaction has a significant impact on rural patient loyalty. Conclusion： Rural patient satisfaction and loyalty to rural doctors is mainly based on kinship and geopolitical relations; given the state of medical technology,the medical environment,medical equipment,service awareness and other restrictions,rural doctors cannot fulfill the ＂gatekeeper＂role,and consequently,the primary healthcare system has been severely affected.