政府购买老年康复服务质量满意度的影响因素

Factors influencing satisfaction of rehabilitation services quality for older people purchased by government

目的 基于多纳伯迪昂(Donabedian)三维质量模型、世界卫生组织《社区康复指南》和《健康服务体系中的康复》构建分析框架,探讨结构和过程变量对政府购买老年康复服务质量满意度的影响。方法 2019年6月至12月,从湖南省长沙市、株洲市和湘潭市随机抽取952名老年人作为调查对象,采用分层回归分析结构和过程变量对居家养老和机构养老康复服务质量满意度的影响。结果 老年康复服务质量满意度总体评价为(21.19±6.84)分,处于中等偏上水平;机构养老老年康复服务满意度为(23.06±7.67)分,明显高于居家养老(19.31±6.85)分(t=7.93,P=0.001)。加入过程变量后,结构变量中只有员工培训可以预测康复服务满意度(B=0.088,P <0.05),财政投入的影响消失(P> 0.05)。过程变量对康复服务质量满意度的影响程度比结构变量大,信息获取、自主性、信任和尊重对待对所有老年人康复服务均具有显著正向影响(B=0.282~0.410,P <0.05)。结论 过程变量是老年康复服务质量满意度的重要决定因素。相关部门应对护理人员和老年人的互动关系等服务过程因素给予更多的关注。

Objective To explore the influence of structure and process variables on the satisfaction of government purchasing pension service quality based on framework of Donabedian Three-Dimensional Quality Model,Community-based Rehabilitation Guideline and Rehabilitation in Health System.Methods From June to December,2019,952 elderly from Changsha,Zhuzhou and Xiangtan in Hunan were randomly selected.Hierarchical regression was used to analyze the influence of structure and process variables on satisfaction of home care and institutional care service quality.Results The satisfaction degree of rehabilitation service quality for older adults was generally abvoe the average level with the score of(21.19±6.84).And the score was higher in the institutional rehabilitation(23.06±7.67) than in the home rehabilitation(19.31±6.85)(t = 7.93,P = 0.001).Among the structural variables,only staffs training could predict the satisfaction of rehabilitation service(B = 0.088,P 0.05) after adding process variables.The effect of process variables on satisfaction degree of quality of rehabilitation services was greater than that of structural variables.Information obtaining,autonomy,trust and treat with respect had significant positive effects on rehabilitation service of all the elderly(B = 0.282~0.410,P < 0.05).Conclusion Process variables are important determinants for satisfaction of rehabilitation service quality.Relevant departments should pay more attention on service process factors such as the interaction between service personnel and the elderly.