臺灣博碩士論文加值系統

Background - The Ministry of Health in Belize has implemented several policies and service level agreements to improve patient satisfaction country wide. Although these initiatives rely on results to appropriately measure patients’ satisfaction with the quality of care, the extent to which a patient’s experience explains his or her satisfaction with the health-care system remains unclear.

Objectives - Despite what may appear to be the general consensus on health care services provided nationally, some health care experiences may very well be more influential than others to the patient in forming their overall satisfaction level. The objective of this study is to ascertain the effects that specific variables have on patients’ overall evaluation of hospital care and their intention to recommend the hospital.

Methods - The HCAHPS Survey was self-administered at the national referral hospital of Belize to inpatients. Simple and multiple step-wise linear regression models were used to identify the predictor factors of patient satisfaction using, separately, the two dependent variables: “Overall evaluation of hospital care” and the “Intention to recommend the hospital”, controlling for age, gender, ethnicity, education and perceived health.

Results - It was found that patient’s highest priority was communication with nurses and doctors encompassing courtesy and respect, taking the time to explain things, and listening to the patients carefully.

Discussion - From the patient’s perspective, the quality of care must include not only the quality of medical care provided but also the quality of caring associated with it. Health-care managers and other decision makers may need to remind their nurses and staff members that patients are experiencing an intensely critical and emotional moment, and thus, they need to provide patient-centered care

ACKNOWLEDGEMENTS I
ABSTRACT II
TABLE OF CONTENT IV
LIST OF TABLES VI
LIST OF FIGURES VII
CHAPTER 1: INTRODUCTION 1
1.1 Background 1
1.2 Belize: The Healthcare System and the People 2
1.3 Statement of the Problem 5
1.4 Significance of the Study 8
1.5 Research Objectives 10
CHAPTER II: LITERATURE REVIEW 11
2.1 Definition of Patient Satisfaction 11
2.2 Development of HCAHPS Survey Instrument 12
2.3 Determinants of Patient Satisfaction 14
2.4 Clinical Staff Influence on Patient Satisfaction 15
2.5 Patient Demographic and Patient Satisfaction 16
2.6 Summary 17
CHAPTER III: METHODOLOGY 18
3.1 Conceptual Framework 18
3.2 Operational Definitions of Variables 19
3.3 Hypotheses 23
3.4 Survey Instrument 25
3.5 Study Setting 26
3.6 Study Sample 27
3.7 Data Source and Collection 28
3.8 Data Analyses 29
3.9 Ethical Consideration 34
CHAPTER 4: RESULTS 35
4.1 Samples’ characteristics 35
4.2 Descriptions of the variables 35
4.2.1 Categorical variables description for ‘Overall evaluation of Hospital Care’ 35
4.2.3 Mean age difference between “Overall Evaluation of Hospital” and “Care Intention to recommend” 36
4.3 Univariate and multivariate analysis for predicting “Overall evaluation of hospital care” 42
4.4 Univariate and multivariate analysis for predicting “Intention to recommend” 45
CHAPTER 5: DISCUSSION 48
5.1 Hospital care factors as predictors of patient satisfaction 48
5.2 Implications of patient demographics on patient satisfaction 50
5.3 Perceived health as a predictor of satisfaction 52
5.5 Recommendations 54
5.6 Implications for further research 55
5.7 Conclusion 57
APPENDIXES 63
Appendix I – HCAHPS Survey Instrument 63
Appendix II – Ethical Approval Request Letter 70
Appendix III – Ethical Approval Letter 71
Appendix IV – Patient Consent Form 72

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