门诊与住院患者满意度驱动机制的差异化研究:基于广东省三级公立医院的实证分析OA

Objective To systematically evaluate the current status of patient satisfaction in tertiary public hospitals in Guangdong Province,identify key drivers influencing service quality,and provide evidence-based insights for precision service improvement.Methods A cross-sectional study design was employed using a localized questionnaire framework integrating the SERVQUAL model and Donabedian's"Structure-Process-Outcome"framework.In September 2022,a stratified random sam-pling survey was conducted among outpatients and inpatients across 203 tertiary public hospitals in the province,yielding 166,343 valid responses.Hierarchical multiple linear regression models were utilized to systematically analyze key factors and impact path-ways influencing overall patient satisfaction at both macro-dimensions and micro-item levels.Results Overall patient satisfaction remained at a high level,with inpatient satisfaction significantly higher than outpatient satisfaction(P＜0.001,Cohen's d=0.216).For outpatients,healthcare delivery processes(β=0.38,P＜0.001)and service attitude(β=0.36,P＜0.001)were identified as the two core drivers.For inpatients,service attitude had the most pronounced impact(β=0.35,P＜0.001),fol-lowed by healthcare delivery processes(β=0.32,P＜0.001).Micro-item analysis further revealed that"ease of registration","informed consent for self-pay items,"and"timeliness of complaint response"were critical improvement points in outpatient set-tings.In contrast,inpatient settings required a prioritized focus on"respectful communication by medical staff"and"billing transparency".Conclusion Inpatient satisfaction is significantly higher than outpatient satisfaction.While healthcare processes and service attitude are universal key drivers,their underlying mechanisms vary by clinical setting.Enhancing outpatient satisfac-tion should focus on process optimization and real-time communication,whereas improving inpatient satisfaction requires deepe-ning humanistic care and financial transparency.It is recommended that healthcare institutions adopt differentiated and precision-targeted strategies to achieve sustained systemic improvements in patient satisfaction.