The Development Of The Quality Evaluation Scale Of Outpatient Service In Public Hospitals From The Perspective Of Patient Demand

ObjectiveThis study was based on Maslow’s hierarchy of needs theory,and set up an evaluation scale for outpatient medical service quality.We evaluated the quality of outpatient medical services from the perspective of patients’ needs satisfaction,so as to provide suggestions for improving the quality of outpatient medical services.Through the application of this scale,hospitals can improve quality of outpatient medical services from the perspective of patients’ needs.MethodsIn this study,we systematically reviewed the literature on patients’ needs,outpatient medical service,quality evaluation theories and methods of services,and formed an evaluation index system of outpatient medical services which was based on Maslow’s demand level.Through the results of Delphi expert consultation,we choose the index with high importance and operability.Further,we used Discrete Degree Method,Correlation Coefficient Method,Discrimination Analysis Method,Factor Analysis Method and Cronbach’sαto screen the indicators,and construct the initial evaluation scale.Principal component analysis was used to determine the weight coefficient of scale,and ultimately form a highly operability evaluation scale with a normalized weight coefficient.Two public hospitals in Hangzhou city were randomly selected to evaluate the quality of outpatient medical service by the scale.T-test was used to analysis whether the outpatient medical service quality of the two public hospitals had statistical significance,and provide suggestions for improvement of outpatient medical service quality.ResultsOn the basis of literature research,our study constructs the evaluation system with 5dimensions and 38 indicators by using the Maslow’s demand level theory.With 2 rounds of Delphi expert advisory research,9 experts evaluated on the importance and operability of indicators,after the first round of expert consultation,they deleted 4 indicators with less importance and poor operability — “intelligent treatment platform for convenient treatment at outpatient service hall”,“external traffic convenience”,“comprehensive health educationservices”,“refuse to the treatment plan provided by doctors”.After the second round of expert consultation,two items of "respecting your religious belief" were deleted.In the results of expert consultation,through the comprehensive degree of discrete degree,correlation coefficient method,discrimination analysis method,factor analysis method and Cronbach’sαto screen,we finally deleted the “A01 solve pain as soon as possible by doctors”with low representative,low distinction,smaller factor loading and reduce the scale of the internal consistency.Deleted the “A03 medical staff’s mental health” with low coefficient of variation,and smaller factor loading and reduce the internal consistency of the scale.On this basis,the evaluation scale were constructed with 6 dimensions of basical needs,economic needs,security needs,attribution and love needs,respect needs and self actualization needs,and30 items.A field survey of 450 outpatients in three public hospitals showed that the half reliability of the scale was 0.967 and the Cronbach’sαwas 0.950.The correlation coefficients between the scores of each item and the total score of the dimensions were statistically significant,P < 0.01,and correlation coefficients of all were greater than 0.6,which indicated that the scale had better content validity.The structure validity of the scale was evaluated by empirical factor analysis.The KMO was 0.918,according to Bartlett ’s sphere test,the chi-square value was 8803.208,P <0.05,and the scale validity was good.The principal component analysis was used to normalize the items,and the results of the evaluation are standardized.We used the scale to grade the quality of outpatient service of two public hospitals in Hangzhou.The results showed that the score of public hospital A was 75.194,while that of public hospital B was 78.829.Through the t test,p < 0.05,the score difference was statistically significant,which indicated that the outpatient service quality of public hospital B was better than that of public hospital A,which further verified the usefulness of the scale.ConclusionBased on Maslow’s hierarchy of demand theory,with expert consultation and quantitative analysis,we constructed a scale for evaluation of outpatient medical service quality.By testing the reliability and validity of the scale,we verified the scientificity and rationality of the scale.Two different hospital’s outpatient patients were investigated by the designed scale.The qualityof outpatient medical services can be compared through this scale,with results of analysis of each dimension of the specific evaluation of hospital outpatient medical service quality,which suggested that the hospital should pay attention to the outpatient medical costs,to provide the services of the knowledge with diseases’ prevention,care,recovery,to satisfy the multilevel needs of patients.And hospitals need to change their concepts,they should focus on the actual medical needs of patients instead of advanced "hardware" and "software" quality of hospital,make up the gap between the supply and demand of outpatient medical services,and build a harmonious environment for patients and doctors.