BİRİNCİ BASAMAK SAĞLIK HİZMETLERİNDE HEKİM SAHİPLENME VE HASTA MEMNUNİYETİ: İLİŞKİSEL HİZMET DENEYİMİ PERSPEKTİFİNDEN KANITLAR

Abstract

Bu çalışma, birinci basamak sağlık hizmetlerinde hekim sahiplenmesi ile hasta memnuniyeti arasındaki ilişkiyi ilişkisel kamu hizmeti deneyimi perspektifinden incelemektedir. Araştırma, Ankara’nın Keçiören ilçesindeki bir aile hekimliği biriminden hizmet alan 332 katılımcıyla kesitsel, tanımlayıcı ve ilişkisel bir tasarım kullanılarak gerçekleştirilmiştir. Veriler yüz yüze anket yöntemiyle elde edilmiş; tanımlayıcı istatistikler, Spearman korelasyon analizi, Mann–Whitney U ve Kruskal–Wallis testleri, Dunn–Bonferroni post-hoc karşılaştırmaları ve PROCESS Macro Model 1 kullanılarak analiz edilmiştir. Sonuçlar, genel hekim sahiplenmesi ile hasta memnuniyeti arasında pozitif ve anlamlı bir ilişki olduğunu ortaya koymuştur. Hekim sahiplenmesinin bağlılık, koruyuculuk, öz kimlik, güven ve uyum boyutlarının her biri de hasta memnuniyeti ile pozitif yönde ilişkili bulunmuştur. Hekim sahiplenmesi ve hasta memnuniyeti düzeylerinin ayrıca hastalık türü, yaş, eğitim düzeyi ve hekime başvuru sıklığına göre farklılık gösterdiği belirlenmiştir. Bunun yanı sıra moderasyon analizi, hekime başvuru sıklığının hekim sahiplenmesi ile hasta memnuniyeti arasındaki ilişkide düzenleyici bir rol oynadığını göstermiştir. Genel olarak bulgular, aile hekimliği hizmetlerinden duyulan memnuniyetin yalnızca hizmet sunumunun teknik özellikleriyle değil, aynı zamanda hekimle kurulan ilişkisel bağ ve bakımın sürekliliği deneyimiyle de ilişkili olduğunu göstermektedir.

Keywords

• Kamu değeri yönetimi
• Kamu hizmeti sunumu
• Hekim sahiplenmesi
• Hasta memnuniyeti

Supporting Institution

Bu çalışmada herhangi bir fon veya destekten yararlanılmamıştır.

Ethical Statement

Yapılan bu çalışmada “Yükseköğretim Kurumları Bilimsel Araştırma ve Yayın Etiği Yönergesi” kapsamında uyulması belirtilen tüm kurallara uyulmuştur. Yönergenin ikinci bölümü olan “Bilimsel Araştırma ve Yayın Etiğine Aykırı Eylemler” başlığı altında belirtilen eylemlerden hiçbiri gerçekleştirilmemiştir

PHYSICIAN OWNERSHIP AND PATIENT SATISFACTION IN PRIMARY HEALTHCARE: EVIDENCE FROM A RELATIONAL SERVICE EXPERIENCE PERSPECTIVE

Abstract

This study examines the relationship between physician ownership and patient satisfaction in primary healthcare from the perspective of relational public service experience. A cross-sectional, descriptive, and correlational design was employed with 332 individuals receiving care from a family medicine unit in Keçiören, Ankara. Data were collected through face-to-face questionnaires and analyzed using descriptive statistics, Spearman correlation analysis, Mann–Whitney U and Kruskal–Wallis tests, Dunn–Bonferroni post-hoc comparisons, and PROCESS Macro Model 1. Overall physician ownership was positively and significantly associated with patient satisfaction (r = 0,469, p < 0,05). All dimensions of physician ownership—commitment, protectiveness, self-identity, trust, and congruence—were also positively associated with patient satisfaction. Both physician ownership and patient satisfaction differed significantly according to disease type, age, and education level. In contrast, physician ownership differed significantly according to the frequency of physician visits, whereas patient satisfaction did not (p = 0,073). Moderation analysis showed that visit frequency significantly moderated the relationship between physician ownership and patient satisfaction (ΔR² = 0,026, p = 0,016), with the association being more pronounced among participants who visited a physician every 2–3 months. Overall, the findings suggest that patients’ evaluations of family medicine services are associated not only with technical and organizational aspects of service delivery but also with the relational bond established with the physician and the experience of continuity in care.

Keywords

• Relational Public Services
• Public Service Delivery
• Physician Ownership
• Patient Satisfaction

Supporting Institution

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors.

Ethical Statement

This study was conducted in full compliance with all principles and rules specified in the Directive on Scientific Research and Publication Ethics of Higher Education Institutions. None of the actions defined under the section “Actions Contrary to Scientific Research and Publication Ethics” of the Directive were committed during the conduct of this study.

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