利用手機QR-CODE進行電腦適性測驗住院病人就醫感受調查可行性探討

Investigating feasibility of inpatient satisfaction survey through QR-code scanned by smart phones via Online Computerized Adaptive Testing

目的：利用手機QR-code進行電腦化適性測驗住院病人就醫感受調查。方法：下載2008年Picker歐洲機構醫院住院病人親身體驗就醫流程感受調查70道題目，分析其調查結果的各題難度，設定題目的單向度性及1,000人的真分數呈常態分佈，利用試題反應理論的Rasch部份給分模式模擬其填卷資料，(A)比較其中24道題目(1)全部作答、(2)隨機挑出12題、及(3)電腦化適性測驗(CAT)等的3種情境之答題效率與準確度；(B)設計手機掃QR-code即可填答Picker住院病人親身體驗就醫流程感受的題目，蒐集病人的回應訊息做後續的探討與分析。結果：驗證CAT較全部作答及隨機挑題來得更具效率，卻又不失其測量準確度。示範智慧型手機掃描QR-code網頁電腦化適性測驗病人住院親身體驗就醫流程感受調查，蒐集病人就醫感受資料的可行性。結論：利用電腦化適性測驗節省病人填答題目卻不失其測量精準度，手機蒐集病人親身體驗流程感受資料的具體可行。

Purpose: To investigate the feasibility of inpatient satisfaction survey through QR-code scanned by smart phones via Online Computerized Adaptive Testing. Methods: Downloaded 2008 inpatient survey data from the website of Picker Europe Institute and analyzed difficulties of these 70-item questionnaire, we used item response theory based Rasch partial credit model (PCM) to simulate 1000 persons' true scores followed by a standard normal distribution. Computerized adaptive testing (CAT) was compared to other two scenarios of the AAI (answering all items) and the RSM (randomized selection method), investigating respondents' item length (efficiency) and measurement accuracy. An author-made web CAT for gathering patients' feedback by scanning the QR-code was demonstrated. Results: We found that the CAT can be more efficient in answering questions than both methods of AAI and RSM without compromising its measurement accuracy. An online CAT inpatient survey by scanning QR-code on smart phones was demonstrated and available for gathering satisfaction responses from patients. Conclusions: The number of answered items is significantly fewer on CAT than on NAT without compromising its precision. The online CAT gathering patients' feedback about hospitalization satisfaction via smart phones is viable and feasible.