基于有限理性理论的患者满意度综合评价研究  

Comprehensive evaluation of patient satisfaction based on bounded rationality theory

作　　者：陈洁 钱宇[2] 王小合[1] 董晓飞 黄仙红[1] 汪慧[1] 郑国管 朱丽娜 Chen Jie;Qian Yu;Wang Xiaohe;Dong Xiaofei;Huang Xianhong;Wang Hui;Zheng Guoguan;Zhu Lina(Department of Medlcine and Health Management,Medical College,Hangzhou Normal University,Hangzhou 310036,China)

机构地区：[1]杭州师范大学医学院卫生事业管理系 ,杭州310036 [2]杭州市第一人民医院,杭州310036

出　　处：《中华医院管理杂志》2018年第9期743-748,共6页Chinese Journal of Hospital Administration

基　　金：国家自然科学基金面上项目（71673075,71273080）

摘　　要：目的针对当前患者满意度测评中普遍存在的条目筛选及权重设计未充分考虑患者期望诉求和能否理性判断等问题，基于有限理性理论进一步完善患者满意度综合评价方案。方法研制满意度测评量表，于2017年7—9月，对847名患者进行现场调查，采用内部一致性检验、相关分析和因子分析，评价量表信效度。基于患者对满意5维度重要性及回答把握程度的评分，计算组合权重PIVi；基于专家咨询对5个维度的重要性与可操作性评分，计算组合权重EIVi；基于调查数据的因子分析和回归分析结果，确定组合权重OWi。联合综合评分法、TOPSIS法、加权秩和比法、灰色关联法、综合指数法，对调查医院患者满意度进行综合评价。结果患者满意度测评量表总CronbachO／系数为0．939，分半信度系数为0．951，因子分析提取5个公因子累计方差贡献率为71．4％。服务环境、服务效率、服务态度、服务技术、服务费用满意5个维度的理性权重依次是0．220、0．214、0．217、0．179、0．171，5种综合评价结果两两相关系数均高于0．95。结论基于有限理性理论研制的患者满意度测评量表，拓展了服务技术和费用等核心指标及内涵，权重设计契合了患者对服务因素的关心及能否理性判断程度，评价结果与当前实际相吻合，可作为患者满意度科学理性评价的参考工具。Objective To further improve the comprehensive evaluation program of patient satisfaction in view of the defective item screening and weight design short of considerations for patients＇ psychological expectation and rational judgment, based on the theory of bounded rationality. Methods A satisfaction measurement scale was compiled and used to survey 847 inpatients in July-August 2017. The internal consistency test, correlation and factor analysis were used to evaluate the reliability and validity of the scale. The combination weight PWi was calculated based on patients＇ importance of the five satisfaction dimensions and the scoring of certainty degree of their responses. The combination weight EWi was calculated based on the five-dimension importance and operability scoring of expert consultation. The indicator combination weight OWi was determined using the integrated factors scoring, TOPSIS, weight ranksun ratio, gray correlation method, and synthetic index method were used in a general assessment of patient satisfaction of a hospital in question. Results The Cronbach ct coefficient of the patient satisfaction rating scale was 0. 939, and the half-reliability coefficient was 0. 951. The cumulative contribution rate of the five common factors variance extracted from the factor analysis was 71. 4%. The rational weights of five dimensions of service environment, service efficiency, service attitude, service technology, and service costs were 0. 220, 0. 214, 0. 217, 0. 179, and 0. 171 respectively, while the comprehensive weights of the five dimensions were 0. 115, 0. 233, 0. 196, 0. 264, and 0. 192 respectively. The comprehensive evaluation results of the two correlation coefficients were greater than O. 95. Conclusions The patient satisfaction measurement scale developed based on the theory of bounded rationality can expand the index connotation and items of core elements such as service technology and cost. The design of index weights fits with the concern of medical service factors and the degree of rationa

关 键 词：患者满意度 有限理性 组合权重 综合评价 量表 

分 类 号：R197.3[医药卫生—卫生事业管理]