Healthcare Opinion Survey Template

Healthcare Opinion Survey Template offers hospital and healthcare organization questions to evaluate the quality, affordability levels, availability, and preferences of customers. You can customize this sample survey questionnaire on the healthcare opinion of patients based on your needs.

The questionnaire typically includes a series of questions that aim to gather feedback about different aspects of the healthcare experience, such as the quality of care provided, communication with healthcare providers, accessibility of services, and overall satisfaction with the healthcare experience.

A healthcare opinion questionnaire can be a valuable tool in gathering feedback from patients, caregivers, and other stakeholders about their experiences with healthcare services. Here are some reasons why you might consider using a healthcare opinion questionnaire:

1. Improving patient satisfaction: By collecting feedback about patient experiences, healthcare organizations can identify areas for improvement and make changes to improve patient satisfaction.
2. Identifying gaps in care: A healthcare opinion questionnaire can help identify areas where patients feel their needs are not being met or where there are gaps in care.
3. Evaluating the effectiveness of interventions: If a healthcare organization has implemented new programs or interventions, a healthcare opinion questionnaire can help evaluate their effectiveness and identify areas for improvement.
4. Prioritizing quality improvement efforts: By analyzing the results of a healthcare opinion questionnaire, healthcare organizations can prioritize their quality improvement efforts based on the feedback they receive.
5. Meeting regulatory requirements: Many regulatory bodies require healthcare organizations to collect patient feedback and use it to improve the quality of care they provide.

Overall, a healthcare opinion questionnaire can help healthcare organizations understand the perspectives of patients and other stakeholders and use that information to improve the quality of care they provide.

Healthcare Opinion Survey Template

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This is the questionnaire that deals with health care and your involvement in health care. Please take a few minutes to express your opinions about the availability and quality of health care in your community. Your answers are important to the success of this study. Thank you for your assistance. Where are you from? Is there a difference in performance between the available hospitals in this area? Yes No Not sure Do you have a preferred hospital? Yes No Is there a difference in the cost of the hospitals in this area? Yes No Not sure Do you receive pressure from other family members to get health care problems taken care of promptly? Yes No Only sometimes Do you feel comfortable judging the differences between hospitals in this area? Yes No Not sure Do you receive care from the same hospital? Yes No Not sure Can you be helpful to friends who are having difficulty making section of a hospital? Yes No Not sure How many years have you lived in this community? How satisfied are you with the skill and competency of the staff? Very satisfied Somewhat satisfied Neutral Somewhat dissatisfied Very dissatisfied Not sure Does the hospital you regularly visit have equipment for modern diagnosis and treatment? Yes No Not sure Does the hospital have modern operating room facilities? Yes No Not sure Overall cleanliness of the hospital Very satisfied Somewhat satisfied Neutral Somewhat dissatisfied Very dissatisfied Not sure Efficiency of nursing care Very satisfied Somewhat satisfied Neutral Somewhat dissatisfied Very dissatisfied Not sure Friendliness and courtesy of staff Very satisfied Somewhat satisfied Neutral Somewhat dissatisfied Very dissatisfied Not sure Convenience of location for you Very satisfied Somewhat satisfied Neutral Somewhat dissatisfied Very dissatisfied Not sure Cost of health care Very satisfied Somewhat satisfied Neutral Somewhat dissatisfied Very dissatisfied Not sure What kind of medical insurance coverage do you have? None Private Employer sponsored Medicaid Medicare Not sure Other How many times have you and any member of your family been to your doctor in the last year? How many times have you visited a friend or loved one in the hospital in the last year? How many times have you and other members of your family been a patient in a hospital in the last 3 years? If quality of service is equal, which source of care would you prefer? I would prefer to go to a walk-in clinic I would prefer to go to my personal physician I would prefer to go to the hospital emergency room Other If you or a member of your family have received medical care at another hospital while living in the [HOSPITAL] area, why did you choose the other hospital? A specialist was available Special hospital care required was not available in the local area My physician practices there More familiar with that hospital Wanted a second opinion from another physician Religious preference Cost was too high in the local area Other When making health care decisions for your family, who is the primary decision maker? Male (or husband) Female (or wife) Jointly (both husband and wife) From your experience in the past, when you or a member of your family needs hospital care, who decides on the hospital? You usually decide You decide based on information from your physician You and your physician decide together Your physician decides based on information you provide Your physician decides Depends on the situation What have you heard about the care patients receive at [Hospital]? The last section of the questionnaire contains a series of questions about your demographic characteristics such as age and income. We are asking these questions in order to determine if various groups have different opinions and attitudes about hospital care. Please answer these personal questions. No one will ever associate these responses with your name. Gender Male Female Age Age(s) of children living in your household: (Check all that apply) < 12 12 - 18 18+ Marital status Married Widow(er) Divorced or separated Have never been married Total household income (from all sources) before taxes for the year [Year]? $25,000 or less $25,000 - $49,999 $50,000 - $74,999 $75,000 - $99,999 $100,000 - $149,999 $150,000 and over Highest level of formal education that you have completed. High school graduate College graduate Completed graduate school PHD Primary occupation? Spouse's primary occupation? Thank you for your assistance.