43 KB69 KB32 KB192920262001Kersnik, Jankoštevilka:7/8letnik:70str. 381-386ISSN:1318-0347COBISSID:13643225URN:URN:NBN:SI:doc-L8UZTK6RslSlovensko zdravniško društvoZdravniški vestnikbolnikidružinska medicinaFamily practiceLogistic modelsMultivariate analysisPatient satisfactionPhysician-patient relationsQuestionnaireszdravstvena negaMultivariantna analiza zadovoljstva bolnikov z zdravnikom družinske medicine| Multivariable analysis of patient satisfaction with family physician|Background. Patient satisfaction is an indicator of the quality of care. Methods. We used an internationally standardised and validated instrument for patients evaluations of general practice care developed in a series of studies. Sample. 60 consecutive patients in 36 practices in Slovenia were approached and offered a self-administered questionnaire. Results. I have got 84% response rate. The respondents mean age was 50 years. 64% were female, and36% male. Higher satisfaction was predicted by eight variables: higher age of the patient, higher number of office visits, aptient satisfaction with the organisation of the health care system, lower self-evaluated health status, lower number of anxiety and depression signs, not being visited in home duringout of hours services, higher number of home visits made by a family practittioner daily and active appointment system. Conclusions. The patients evaluate parts of the health care system as a whole. The survey showed necessary changes in order to improve patient satisfaction. Introduction of appointment system in primary care seems to be unavoidable. Communication skill besides family medicine curricula and vocational training in family medicine should be included in each curricula for undergraduate teaching as well in vocational training. Those who did not benefit of such training courses in communication skills should be offered. Home visits as one of the basic characteristics of family practice should be supported professionally and with financial incentivesIzhodišča. Zadovoljstvo bolnikov je eden izmed kazalnikov kakovosti dela zdravnika. Metode. Uporabil sem EUROPEP vprašalnik, ki je bil razvit v mednarodni študiji in poprej testiran. Na podlagi podatkov o zdravnikih družinske medicine in njihovih ambulantah smo pripravili stratificiran vzorec 36 zdravstvenih ustanov in v vsaki izbrali po enega zdravnika, ki je v marcu 1998 60 zaporednim bolnikom dal vprašalnik s frankirano in naslovljeno ovojnico, na kratko pojasnil namen raziskave in pridobil ustni pristanek za bolnikovo sodelovanje. Po 14 dneh so anketiranci prejeli opomnik. Rezultati. 84% (1809/2160) bolnikov je vrnilo vprašalnike. Povprečna starost je bila 50 let, 64% je bilo žensk in 36% moških. Večje zadovoljstvo pojasnjuje osem neodvisnih spremenljivk: višja starost bolnika, večje število obiskov v ambulanti, bolnikovo zadovoljstvo z organizacijo sistema zdravstvenega varstva, nižja ocena zdravja, manjša prisotnost znakov anksioznosti in depresije, manj hišnih obiskov dežurnega zdravnika, večje število hišnih obiskov, ki jih dnevno opravi zdravnik družinske medicine, in vpeljan sistem naročanja na pregled pri zdravniku. Zaključki. Bolniki na sistem zdravstvenegavarstva gledajo celovito, zato morajo vsi njegovi sestavni deli skrbeti za čim večje zadovoljstvo uporabnikov. Med elementi, ki jih je možno izboljšati in s tem dvigniti raven zadovoljstva je uvedba sistema naročanja napregled v vseh ambulantah v osnovnem zdravstvu. Pouk o sporazumevanju med zdravnikom in bolnikom je treba poleg pouka iz predmeta in specializacije iz družinske medicine vključiti tudi v programe drugih fakultetnih predmetov in vspecializacij, predvsem pa zdravnikom, ki tega izobraževanja niso bili deležni, omogočiti tako izobraževanje v stalnem podiplomskem izpopolnjevanju. Hišni obisk kot eno specifičnih sestavin svebine dela zdravnika družinske medicine je treba podpirati s strokovnim izobraževanjem o delu izven ambulantein z ustreznim finančnim ovrednotenjem takega delaTEXTznanstveno časopisjejournalsSlovenian National E-content AggregatorNational and University Library of SloveniaSlovensko zdravniško društvo