Construction And Empirical Analysis Of Large Comprehensive Hospitals’ Patient Satisfaction Index Model

With the deepening reform of China’s medical and health system, gradually openingof medical service market, medical institutions is faced with increasingly intensemarket competition. Medical institutions, especially the Large ComprehensiveHospitals, win the trust of patients in competition and make the hospital constructionstepping into the benign orbit of sustainable development, only when they ensuredsatisfied medical services provision to patients. At present, in the modern hospitalmanagement evaluation index system, Patient Satisfaction is key criteria of appraisingthe treatment impact and medical service quality. Carring out the study on PatientSatisfaction is of great theoretical and realistic significance to improving healthquality management theory and guiding medical institution to improve targetedservices. As the main body in medical and health system and assumed to be regionalmedical centers, Large Comprehensive Hospitals should pay more attention to PatientSatisfaction and promote hospitals’ development according to patients’ demand.As patient satisfaction study in China started comparatively late, at present, there aremany problems demanding prompt solution in theoretical and practical exploration. In2010, a scientific research project of Study on Large Comprehensive Hospitals’Patient Satisfaction Evaluation Index System being officially approved byChina-Japan Friendship Hospital affiliated to Chinese Ministry of Health, hoped touse the scientific method to optimize the indicators of the Large ComprehensiveHospitals’ Patient Satisfaction Scale, build up a more scientific and reasonableevaluation index system, construct the patient satisfaction index model and develop apatient satisfaction evaluation information system so as to offering some help forhospital quality improvement and services developing strategies. This dissertation is areflection of the research production.On the basis of extensive research achievements at home and abroad, this dissertationconstructed and empirical analyzed the Large Comprehensive Hospitals’ Patient Satisfaction Index Model, with the combination of hospitals’ practices and theoreticalresearch, traditional probability statistics theory and modern grey theory and fuzzymathematics, on-site investigation and sampling and information technology. Themain results and conclusions obtained are as follows:1. Based on the repeated design, investigation, analysis and modification of theinitial scale and the preliminary survey scale, this study conducted samplingsurvey in5domestically influential Large Comprehensive Hospitals which wasrespectively chosen form northern China, southern China, central China, easternChina and southwest China.The survey data were processed by explorative factoranalysis and confirmatory factor analysis to construct the multi-level largegerneral hospital patient satisfaction evaluation index system and form LargeComprehensive Hospitals’ Patient Satisfaction Evaluation Questionnaire.2. Using the method of combining the multilayer linear model with structuralequation modeling, this sudy innovated the multi-level model of LargeComprehensive Hospitals’ Patient Satisfaction Index (LCHPSI). By empiricalanalysis of the model, it was confirmed that the causal relationship between thelatent variables and observed variables was correct and the model structure fittedthe actual data.3. By research on LCHPSI model of different order, it was found that, in essence,there is no fundamental difference in adopting the second-order model or thefirst-order model and it would not affect the determination of the satisfactionindex. Thus the discussion of the different hierarchies affect the results of thesatisfaction index or not was settled.4. This study conducted multi-level fuzzy comprehensive evaluation of patientsatisfaction based on sorting method for factor weights. Such a direct objectiveweighting method on a basis of statistical data of patients made the weightcoefficients assignment more objective. Combined with the multi-level fuzzycomprehensive evaluation method, the evaluation results tended to be truer. It wasproved effective through empirical analysis.5. This study also conducted multi-level fuzzy comprehensive evaluation of patient satisfaction based on grey relational analysis for factor weights. Several modernmathematical tools used in conjunction reduced the expert differences caused bythe deviation to a certain extent and made the patient satisfaction evaluationachieve better results.6. Through the empirical analysis, this study compared the two objective weightingmethod above and founded that the comprehensive evaluation results of these twomethods were basically the same whereas the multi-level fuzzy comprehensiveevaluation method of patient satisfaction based on sorting method for factorweights got higher overall satisfaction scores than the multi-level fuzzycomprehensive evaluation method of patient satisfaction based on grey relationalanalysis for factor weights.7. Based on grey fuzzy theory, this study developed Patient Satisfaction EvaluationInformation System which realized the automation of hospitals’ patientsatisfaction evaluation. This information system carried on objective patientsatisfaction evaluation by adapting to the uncertainty caused by the incompleteevaluation data of patient satisfaction and achieving comparatively exactdescription and understanding of default values through part of knowninformation.The main innovations of this dissertation:1. Adopting the method combining multi-level linear model with structural equationmodeling, a second-order Large Comprehensive Hospitals’ Patient SatisfactionIndex (LCHPSI) model was created. Such a multi-level patient satisfaction indexmodel, could reasonably estimat that single observed variable’s influence onsatisfaction, and even compare the patient satisfaction on different levels indifferent fields of medical services.2. By research on patient satisfaction index model of different order, it wasconcluded that the order of patient satisfaction index model would not infiluencethe determination of patient satisfaction index, so as to provide some reference forresearchers studying on multi-level patient satisfaction index model. 3. Proposing the method of multi-level fuzzy comprehensive evaluation of patientsatisfaction based on sorting method for factor weights, the determination of theweighting coefficients at all levels of the multi-level model was innovated, so asto make the weight coefficients assignment relatively objective and the evaluationresults truer.4. The multi-level fuzzy comprehensive evaluation method of patient satisfactionbased on grey relational analysis for factor weights was also proposed. As acombination of grey theory and fuzzy mathematics, this new approach overcamethe restrictions of sample size and regularity, made up for the deficiencies of thetraditional statistical methods, and reduced the deviation caused by expertdifferences to a certain extent.