基于顾客满意度指数模型的住院患者满意指数模型构建与实证研究

发布时间：2018-04-10 01:38

本文选题：住院患者满意度　切入点：美国顾客满意度指数模型　出处：《青岛大学》2017年硕士论文

【摘要】：目的以美国顾客满意度指数模型为基础,构建我国住院患者满意度评价指标体系,形成住院患者满意度量表;采用住院患者满意度量表对住院患者进行调查,构建我国住院患者满意度指数模型,并对指数模型进行评价。方法在文献研究的基础上,以美国顾客满意度指数模型为理论基础,结合我国医疗行业具体情况,形成专家函询问卷。采用德尔菲专家函询法对护理管理和临床护理领域的15名专家进行两轮专家函询,最终确立住院患者满意度评价指标体系,形成住院患者满意度量表。运用结构方程方法构建住院患者满意度指数模型,采用住院患者满意度量表对560例住院患者进行问卷调查,运用SPSS17.0和AMOS22.0软件对调查的数据进行统计分析和模型评价。结果1.两轮专家函询问卷回复率分别为100%和93.33%,两轮函询专家的权威系数分别为0.87和0.91,第二轮专家函询各个条目的变异系数介于0.05~0.23之间。最终确定的住院患者满意度指标体系包括医院形象、疾病压力、约束条件、患者期望、感知质量、感知价值、患者满意度、患者忠诚和患者抱怨9个一级指标、32个二级指标和39个三级指标。2.构建了基于ACSI模型的我国住院患者满意度指数模型。模型包括医院形象、疾病压力、约束条件、患者期望、感知质量、感知价值、患者满意度、患者抱怨和患者忠诚9个潜变量和24个观测变量。3.住院患者满意度量表的总体Cronbach'sα系数为0.857,九个维度的信度范围为0.733~0.876。内容效度指数(CVI)为0.89,各条目的CVI为0.86~0.95。因子分子结果显示9个维度的因子共解释总变异率为75.377%,表明问卷具有良好的信效度。4.结构方程模型显示:医院形象、疾病压力、约束条件、患者期望、感知质量和感知价值对患者满意度的标准化路径系数分别为0.37、㧟0.46、㧟0.39、㧟0.58、0.64、0.54,患者满意度对患者忠诚和患者抱怨的标准化路径系数分别为0.42和㧟0.52,差异具有统计学意义(P0.05)。5.模型拟合效果:卡方自由度比值为2.247,渐进残差均方根为0.042,GFI、AGFI、NFI、IFI、TLI及CFI的值均大于0.9,表明模型拟合较好,可以接受。结论1.本研究构建的住院患者满意度评价指标体系,为住院患者满意度评价提供了科学的参考依据。2.形成的住院患者满意度量表具有较好的信效度,可作为医院评价住院患者满意度的工具。3.构建的住院患者满意度指数模型中所有回归系数均具有统计显著性,通过显著性检验,模型拟合较好,可为国内住院患者满意度指数模型的类似研究提供参考。
[Abstract]:Objective based on the American customer satisfaction index model, to construct the evaluation index system of inpatient satisfaction in our country, to form the inpatient satisfaction scale, and to investigate the inpatient satisfaction scale by using the inpatient satisfaction scale.The index model of inpatient satisfaction in China was constructed and evaluated.Methods on the basis of literature study, an expert questionnaire was formed based on the American customer satisfaction index model and the specific situation of medical industry in China.Two rounds of expert inquiry were conducted on 15 experts in nursing management and clinical nursing field by Delphi's expert inquiry method. Finally, the evaluation index system of inpatient satisfaction was established, and the inpatient satisfaction scale was formed.The index model of inpatient satisfaction was constructed by using structural equation method. The questionnaire survey was carried out on 560 inpatients with the inpatient satisfaction scale. The data of the survey were statistically analyzed and evaluated by SPSS17.0 and AMOS22.0 software.Result 1.The response rates of the two rounds of expert questionnaire were 100% and 93.33 respectively, the authoritative coefficients of the two rounds of experts were 0.87 and 0.91 respectively, and the coefficient of variation of each item in the second round of expert letter was between 0.05 and 0.23.The final index system of inpatient satisfaction includes hospital image, disease stress, constraint conditions, patient expectation, perceived quality, perceived value, patient satisfaction,Patient loyalty and complaint 9 first class indicators, 32 secondary indicators and 39 third grade indicators. 2. 2.The index model of inpatient satisfaction in China based on ACSI model is constructed.The models included hospital image, disease stress, constraints, patient expectation, perceived quality, perceived value, patient satisfaction, patient complaint and patient loyalty 9 latent variables and 24 observational variables .3.The overall Cronbach's 伪 coefficient of inpatient satisfaction scale is 0. 857, and the reliability range of nine dimensions is 0. 733 卤0. 876.The content validity index (CVI) was 0.89, and the CVI of each target was 0.860.95.The results of factor molecular analysis showed that the total variation rate of coexplanation of 9 dimensions was 75.377, which indicated that the questionnaire had good reliability and validity.The structural equation model shows: hospital image, disease stress, constraints, patient expectations,The standardized path coefficients of perceived quality and perceived value to patients' satisfaction were 0.37 / 0. 46 / 0.39 / 0.38 / 0. 64 / 0.54, respectively. The standardized path coefficients of patients' satisfaction to patients' loyalty and complaint were 0.42 and 0. 52, respectively. The difference was statistically significant (P < 0. 05).The fitting results showed that the chi-square degree of freedom ratio was 2.247, the mean square root of progressive residual error was 0.042%, the values of TLI and CFI were all greater than 0.9, which indicated that the model fitted well and was acceptable.Conclusion 1.The evaluation index system of inpatient satisfaction is constructed in this study, which provides a scientific reference basis for the evaluation of inpatient satisfaction.The inpatient satisfaction scale has good reliability and validity and can be used as a tool to evaluate the inpatient satisfaction. 3.All regression coefficients of the inpatient satisfaction index model were statistically significant. Through significance test, the model fitted well, which could be used as a reference for the similar research of domestic inpatient satisfaction index model.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R47

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