한방병원에 내원한 암환자 100예에 대한 한방치료 만족도 및 내원 동기 조사연구

Survey on Satisfaction with Korean Medicine Treatment and Motives for Visiting Korean Medicine Hospital for Cancer Patients: Report of 100 Cases

Article information

J Int Korean Med. 2021;42(4):475-487

Publication date (electronic) : 2021 September 30

doi : https://doi.org/10.22246/jikm.2021.42.4.475

Hyeon-muk Oh ¹, Sul-ki Kim ¹, Chan-ran Park ³, Myung-hyun Ko ¹, So-jung Park ¹, Chong-kwan Cho ¹, Ji-hye Park ², Hwa-seung Yoo ², Nam-hun Lee ³, Chang-gue Son ¹, Jung-hyo Cho ¹

오현묵¹, 김슬기¹, 박찬란³, 고명현¹, 박소정¹, 조종관¹, 박지혜², 유화승², 이남헌³, 손창규¹, 조정효¹

¹ 대전대학교 부속 대전한방병원

Dept. of Internal Medicine, Daejeon Korean Medicine Hospital of Dae-Jeon University

² 대전대학교 부속 서울한방병원 내과

Dept. of Internal Medicine, Seoul Korean Medicine Hospital of Dae-Jeon University

³ 대전대학교 부속 천안한방병원 내과

Dept. of Internal Medicine, Cheonan Korean Medicine Hospital of Dae-Jeon University

·Corresponding author: Jung-hyo Cho Dept. of Internal Medicine, Korean Medicine Hospital of Daejeon University, Daedeok-daero 176 beon-gil 75, Seo-gu, Daejeon, Korea TEL: 042-470-9161 FAX: 042-470-9005 E-mail: choajoa@dju.ac.kr

Received 2021 September 2; Revised 2021 September 29; Accepted 2021 September 29.

Abstract

목적

본 연구는 대전대학교 부속 한방병원에서 암을 주소로 입원치료를 받은 환자를 대상으로 내원 동기 및 만족도를 평가하고자 한다.

방법

총 100명의 입원환자를 대상으로 의료서비스 만족도 측정을 위한 설문조사를 실시하였다. 통계분석은 독립표본 T검정(Independent t-test), 분산 분석(ANOVA)을 사용하였다.

결과

암환자들이 한방병원에 내원한 주된 동기는 ‘암의 전이 및 재발을 예방하기 위해서’로 조사되었다. 환자들은 한방 치료 중 침과 뜸에 대해 가장 높은 만족도를 보였다. 5점 척도로 구성된 만족도 조사에서 한의사 서비스와 관련된 만족도는 평균 4.80점, 의료서비스 이용 관련 만족도는 4.68점으로 나타났다.

결론

대부분의 암환자는 한방병원의 의료서비스에 만족하는 것으로 나타났고 성별, 연령 및 직업에 따른 한방 의료서비스 만족도에는 유의한 차이가 없었다.

Trans Abstract

Objectives

This study aimed to evaluate the degree of satisfaction of cancer patients and to understand their motives for visiting Korean Medicine Hospital in order to increase satisfaction with Korean medicine among cancer patients.

Methods

Data collection was conducted in the form of a survey of 100 inpatients who responded to a self-report questionnaire. Independent t-test and analysis of variance (ANOVA) were used for data analysis.

Results

The main reason for visiting Korean Medicine Hospital was to prevent metastasis or recurrence of cancer. Patients showed the highest satisfaction with acupuncture and moxibustion. The average degree of satisfaction related to the doctor service was, on a 5-point scale, 4.80, and that of using procedure was 4.68.

Conclusion

Most of the cancer patients are satisfied with the medical services in Korean Medicine Hospital. There were no significant differences in satisfaction degree by gender, age, or occupation.

Keywords: patient satisfaction; Korean medicine; cancer

Keywords: 환자 만족도; 한의학; 암

I. Introduction

Cancer can be considered as the first and leading public health issue, which poses the highest clinical, social, and economic burden1. The number of cancer survivors continues to increase because of advances in early detection and treatment2. However, despite tremendous efforts to conquer cancer, there are still limitations in treating for end-stage cancer and various types of cancers, and is also a problem of side effects from surgery and chemotherapy3. Therefore, interest in complementary and alternative medicine for treating cancer is increasing worldwide4.

Cancer patients are choosing various treatments options such as Korean Medicine treatment in addition to standard treatment in Korea. According to one study, it was found that 31% of all cancer patients use Korean medicine treatment in Korea5. Various researches on cancer treatment using Korean medicine are being conducted in Korea, for example, cancer regression and angiogenesis inhibition6. In addition, many studies have been published that reporting the effect of improving the quality of life and treating side effects after chemotherapy, radiation, and surgery through Korean medicine treatment7,8.

For the development of Korean medicine cancer treatment, it will be helpful to establish the direction of research on cancer through assessment of the motives for choosing Korean medicine hospital and satisfaction of Korean medicine cancer treatment by patients. Despite this necessity, the evaluation data on Korean medicine cancer treatment are very scarce. In one study, the satisfaction of cancer patients who visited Korean medicine hospitals was reported, but the number of participants was small and it was only conducted in one institution9.

Therefore, we conducted this study to investigate the satisfaction of cancer patients who received inpatient treatment at Korean medicine hospital by surveying the motives of visiting the hospital and the satisfaction of medical services.

II. Methods

1. Research setting and data collection

This study was conducted on 100 inpatients who were admitted for cancer therapy in three Korean Medicine Hospital (Cheonan, Daejeon, Seoul) of Daejeon University during the period of November 2020 to May 2021.

Study participants were selected as patients who can communicate and respond to questionnaires. Sample selection limited to those who had been hospitalized for more than 3 days considering that the 2 days were judged as a period of adaptation to the hospital environment, medical staff and facilities. The protocol was approved by the institutional review board in Daejeon Korean Medicine Hospital (institutional review board number : DJDSKH- 20-E-36).

2. Method

We used modified and supplemented version of questionnaire developed by Park et al (2015)9 which is a similar study to measure the satisfaction of cancer patients’ medical service. and. After explaining the questionnaire for inpatients, the consent was obtained from participants. The patients received the questionnaire the previous day before being discharged and returned it before leaving hospital.

The questionnaire was composed of a total of 18 questions, including three major parts (1) demographic characteristics, (2) use-related characteristics, (3) medical service satisfaction. The detailed items of medical service satisfaction are 5-questions on satisfaction with doctor services and 5-questions on medical use procedures. Each satisfaction score was composed of a 5-point scale, and the higher the score, the higher the satisfaction was evaluated.

3. Statistical analysis

Statistical analysis was performed using SPSS version 28.0 software for Windows (SPSS, Chicago, IL, USA). Collected data were computerized using Microsoft Excel software (Microsoft, Redmond, WA, USA) and non-responded items were excluded from analysis. Demographical characteristics were quantified with frequencies and percentages. For motivation and satisfaction for medical service, the mean and standard deviation were calculated and analyzed. To figure out the satisfaction of the medical service of cancer patients using Korean Medicine Hospital, mean and standard deviation were calculated. In order to find out the difference in satisfaction of medical service according to the general characteristics and use-related characteristics, independent t-test (t-test), analysis of variance (ANOVA) were used for analysis. A significance level of 0.05 was used throughout. Internal consistency of the questionnaire was measured using Cronbach’s α coefficient.

III. Results

1. Subjects characteristics

1) Demographic characteristics

Of the total 100 subjects, 26 (26%) were male and 74 (74%) were female. Table 1 shows demographic characteristic of the participants. The most common age group was 50-59 years. Distribution by age was 1 (1%) under 40-year, 23 (23%) under 50-year, 47 (47%) under 60-year, 23 (23%) under 70-year, 6 (6%) over 70-year. Regarding occupation, housewife was the most frequent occupation.

Table 1

Demographic Characteristics of Subjects

2) Korean Medicine Hospital use-related characteristics

As seen in Table 2, after cancer diagnosis, 10 patients (10%) visited the Korean Medicine Hospital for the first time, and 90 patients (90%) came to the Korean Medicine Hospital via a local clinic or general hospital. As for the year of diagnosis, it was less than 1 year in 15 (15%), 1~2 years in 50 (50%), 3~4 years in 21 (21%), more than 4 years in 14 (14%). Regarding the duration of admission, it was less than 1 week in 15 (15%), 1~2 weeks in 49 (49%), 3~4 weeks in 8 (8%), 4~8 weeks in 8 (8%), and more than 8 weeks in 20 (20%). About the number of admission, 31 patients (31%) were hospitalized once, 33 patients (33%) were hospitalized 2 to 5 times, 14 patients (14%) were hospitalized between more than 5 times to within 1 year, and 21 patients (21%) were hospitalized for multiple years.

Table 2

General Characteristics of Subjects Visiting Korean Medicine Hospital of Cancer Treatment

Of the 100 respondents, 23 (23%) answered that they had visited Korean Medicine Hospital in the past. And among this 23 patients, 8 (29.6%) were very satisfied with the Korean medical service they received in the past, 11 (40.7%) were satisfied, and 8 (29.6%) answered ‘neutral’. No one answered that they were dissatisfied or very dissatisfied (Table 2).

As for the route that led to the choice of Korean Medicine Hospital, there were 11 patients (11.8%) choosing through ‘Reporting on TV, newspapers, the Internet, etc.’, 2 patients (2.2%) through ‘Seeing review of others on website or etc.’, 61 patients (65.6%) through ‘Recommendations from others’, 18 patients (19.4%) through ‘Search by oneself’, and 1 (1.1%) other has previously known about the hospital. When asked about willingness to recommend to others, 97 (97%) answered ‘yes’ and 3 (3%) said ‘Don’t know’ (Table 2).

The distribution of satisfaction scores was highly lean toward the satisfaction direction. The answers to overall satisfaction were; ‘very satisfied’ in 43 patients (43%), ‘satisfied’ in 48 patients (48%), ‘neutral’ in 9 (9%), ‘dissatisfied’ and ‘very dissatisfied’ in 0 (0%). Regarding cost of treatment, 21 (21.6%) of respondents answered that the cost of hospital treatment was very satisfactory, 38 (38.0%) said that was satisfactory, 33 (34.0%) told that was moderate (neutral), 3 (3.1%) responded that was unsatisfactory and 2 (2.1%) answered that was very unsatisfactory. About the intention to reuse, 97 respondents (97%) answered yes, 1 (1%) answered no, and 2 (2%) answered that they didn’t know. Regarding the intention to visit outpatient after discharge, 79 (80.6%) respondents answered yes, 1 (1.0%) answered no, and 18 (18.4%) answered that they didn’t know (Table 2).

As for the motivation for selecting Korean Medicine Hospital after cancer diagnosis, 43 patients (43.4%) answered that it was ‘For enhancing cancer-related immune system or reducing adverse events after chemotherapy’. 35 patients (35.4%) answered that it was ‘For preventing metastasis or recurrence’, 32 patients (32.3%) answered that it was ‘For symptom management’, 3 patients (3%) answered that it was ‘For treating cancer only with Korean medicine’ (Table 3).

Table 3

Motivation for Selecting Korean Medicine Hospital for Cancer Treatment

Regarding the reason for choosing ‘Daejeon Korean Medicine Hospital’ among Korean Medicine Hospital, the respond ‘Because the skills of the medical staff were excellent’ was 4.39 (0.81), which had the highest average score. Next, the scores are listed in order, ‘Because the hospital staff are kind’ was 4.37 (0.82), ‘Because academic research and drug development are being actively carried out as university hospital’ was 4.14 (0.87), ‘Because hospital’s facilities and equipment are satisfactory’ was 4.01 (0.92), ‘Because it is easy to access or transportation is convenient’ was 3.78 (1.20), ‘Because the hospital staff are well aware of the patient’s information because of previous visits’ 3.41 (1.30), and ‘Because the cost of treatment is cheap’ 2.76 (1.05) (Table 4).

Table 4

Motivation for Selecting ‘Daejeon Korean Medicine Hospital’ for Cancer Treatment

The most satisfied treatment item during admission was ‘Acupuncture’ (71.8%), followed by ‘moxibustion’ (28.2 %), ‘Manual therapy’ (16.5%), ‘Herbal medicine’ (15.3%) (Table 5).

Table 5

Satisfaction by Treatment Item

2. Satisfaction for medical service

As a result of surveying the satisfaction of each medical service use unit through doctor service and medical service using procedures, the factor-wise internal consistency was 0.850 for doctor service, 0.861 for medical service using procedure, indicating high level of confidence.

Regarding the satisfaction degree of doctor service, the average of satisfaction degree of doctor service was 4.80±0.40, and the satisfaction with the item description ‘response and sufficient explanation for usual questions from doctor’ was found to be the highest at 4.86±0.38 (Table 6). The average level of satisfaction degree of using procedure was 4.68±0.44, and the satisfaction with the convenience of reception was the highest at 4.78±0.46 (Table 7).

Table 6

Satisfaction Degree of Doctor Service

Table 7

Satisfaction Degree of Using Procedure

The results of comparing the differences in satisfaction degree with doctor services by gender, age, and occupation of the patients were as follows. Satisfaction degree of doctor service was 4.89±0.24 for men and 4.77±0.44 for women. Satisfaction degree of using procedure was 4.82±0.29 for men and 4.62±0.47 for women. The p-values were 0.075 and 0.007, respectively, indicating that males were more satisfied than females (Table 8).

Table 8

Satisfaction Degree by Sex

About the differences by age, the satisfaction degree of doctor services under the age of 40 was the highest at 5.00, but only in one patient. And those over the age of 70 were found to be as high as 4.96±0.10, and those aged 40-49 years, 60-69 years, 50-59 years as followed. Those over 70 years old showed the highest level of satisfaction degree of using procedure, with 4.90±0.24, followed by 40-49 years old, 50-59 years old, 60-69 years old, and under 40 years old. The respective p-values were 0.717 and 0.236, representing that there was no difference in satisfaction degree by age (Table 9).

Table 9

Satisfaction Degree by Age

Regarding the differences by occupation, the satisfaction degree of doctor service was highest in the case of engineers or students and etc. at 5.00, and the satisfaction degree of using procedure was the highest in the case of engineers at 4.93±0.12, with p-values of 0.545 and 0.474, respectively. There was no difference in satisfaction according to occupation (Table 10).

Table 10

Satisfaction Degree by Occupation

IV. Discussion

Patient satisfaction and medical service quality has recently been regarded as an important issue in evaluating the performance of health care providers10. Patient perspectives of the quality of health care services provided are somewhat subjective given that patients have limited know ledge of health care-related information. Health care providers can identify the service design and delivery improvements that contribute to patient satisfaction and revisit intention11. Consequently, patients’ satisfaction is an important criterion for assessing the performance of the medical services and determinant of compliance with the doctor12. Higher patient’s satisfaction levels contribute to the results in terms of improved prognosis, less negligence lawsuits. Therefore, patient satisfaction is a predictor of future health13.

However, research on Korean Medical services for cancer patients is insufficient, so it was determined that such a study was necessary to increase patients’ satisfaction and promote reuse of Korean Medicine Hospital. Accordingly, our research team conducted this study to investigate the satisfaction of cancer patients using a questionnaire that modified the basic items of SERVQUAL, a measure for evaluating service quality, according to Korean Medicine Hospital14.

The demographic characteristics showed that women in their 50s accounted for a large proportion and most of the occupations are housewives. It is thought that middle-aged women choose inpatient treatment because they have more time than others.

Considering the general characteristics of Korean Medicine Hospitals, most of respondents went general hospital and then visit Korean Medicine Hospital after cancer diagnosis. A large proportion of patients answered that the reason for visiting Korean Medicine Hospital was to prevent metastasis or recurrence, and to enhance cancer-related immune system or to reduce adverse events after chemotherapy, suggesting that they are visiting Korean Medicine Hospital for an supplementary purpose in the course of cancer treatment.

In general, the period of hospitalization on cancer patients was limited to 2-3 weeks, so the most patients received inpatient treatment for 2-3 weeks. And the number of admission over 2 times was 69%, showing high reuse rate. It can be confirmed that 97% of those who intend to reuse in the future and 79% of those who intend to use it as an outpatient are consistent with the above results. It can be confirmed that 97% of those who intend to reuse in the future and 79% of those who intend to visit outpatient are consistent with the above results. It was found that recommendations from others were the most likely route for patients to choose Korean Medicine Hospitals. Hospital visiting from TV, newspaper, and Internet promotions or review on website was low, indicating that cancer treatment by Korean Medicine was not sufficiently publicized. Therefore, it is necessary to promote advantages of Korean Medicine cancer treatment through various methods in the future.

The motivation for visiting our ‘Daejeon Korean Medicine Hospital’ among various Korean Medicine Hospital was that the skill of the medical staff and the kindness of the hospital staff played an important role. These results represent that patients are positively accepting the effect of Korean Medicine on managing side effects in the course of cancer therapy (reference). Also, this results consistent with the fact that the importance of friendly service is being emphasized15. In the case of Korean Medicine, there are many treatment items that cannot be covered by public health insurance, so there are many cases where patients feel burdened by cost. In fact, 35.2% answered that they were not satisfied with the cost of treatment. Acupuncture treatment was the most satisfactory treatment item among the treatment items (71.8%), as various research reported that acupuncture was effective for the symptoms of cancer patients after surgery, chemotherapy and radiotherapy16.

Because there was no significant difference between each item in doctor service satisfaction and satisfaction with the using procedure, no meaningful results could be obtained. Satisfaction with doctor service (4.80) was higher than satisfaction with using procedure (4.68). In the doctor service, males showed higher satisfaction than females according to gender, but there were no significant differences according to gender, age, and occupations in the remaining results. Most of the inpatients tend to be friendly to doctors and hospital staff, so there is a limit to check the defects to be supplemented in this satisfaction survey. According to a study examining 420 cancer patients’ satisfaction in university hospital, it was found that the quality of medical services which are medical expertise, administrative service had a significant effect on patient satisfaction17. There seems to be no difference between general hospital and Korean Medical Hospital in the factors determining the patient satisfaction.

Taken together, most of the patients admitted to Korean Medicine Hospital for cancer treatment showed a tendency to be satisfied with the treatment and services of Korean Medicine Hospital. Satisfaction with treatment methods tends to be heavily weighted towards acupuncture and moxibustion, so various attempts to use various Korean Medical services such as pharmacoacupuncture and herbal medicine should be continued. The excellence and effectiveness of Korean Medicine on cancer treatment should be promoted through various methods such as advertising and research. In addition, it is necessary to continuously conduct research on cancer treatment, so that it can go one step further and become a major hospital in cancer treatment. Also if the shortcomings are supplemented, more people will be able to receive high-quality Korean Medical services, and it is thought that patient satisfaction will also increase.

This study has several limitations. 1) This study was conducted on three Korean Medicine Hospitals affiliated with the Daejeon university, so it is difficult to evaluate the level of medical service of Korean Medicine Hospital for cancer patients based on the results of this study alone. 2) In addition, most of the patients who responded to the questionnaire were middle-aged women. Future studies are needed to expand the range of patients. 3) In Korean Medicine Hospitals, treatment items could be different depending on patients’ personal insurance. This is important bias that can affect satisfaction degree in relation to cost. 4) Characteristics and statistical information according to type of cancer is not presented. This should be considered in future studies.

The results of this study are meaningful in confirming the positive perception of cancer patients on Korean Medicine cancer treatment. We could see that the satisfaction with Korean medicine treatment of cancer patients is relatively high. To improve the quality of services continuous research is needed in the future.

Acknowledgments

None. No funding to declare.

Conflicts of Interest

No conflicts of interest.

Author contribution statement

Hyeon-Muk Oh wrote the main manuscript text, and conducted survey. Seul-Gi Kim and Chan-Ran Park conducted survey. So-Jung Park, Ji-Hye Park performed a statistical analysis. Chong-Kwan Cho, Hwa-Seung Yoo, Nam-Heon Lee, Chang-Gue Son and Jung-Hyo Chosupervised the manuscript, and directed final version of all contents. All authors reviewed and approved this manuscript.

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Article information Continued

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Variable	Number	%
Sex
Male	26	26
Female	74	74
Age
< 40	1	1
40~49	23	23
50~59	47	47
60~69	23	23
≥ 70	6	6
Occupation
Inoccupation	8	8
Housewife	46	46
Self employmentor Service	15	15
Student or etc.	5	5
Office worker	15	15
Engineer	8	8
Professional	5	5
Total	100	100

Table 2

General Characteristics of Subjects Visiting Korean Medicine Hospital of Cancer Treatment

Variable		Total
		Number	%
		Immediate visit after cancer diagnosis	Yes	10	10
No	90	Immediate visit after cancer diagnosis	90
Year of diagnosis	Within 1 year	15	15
	1~2 years	50	50
	3~4 years	21	21
	> 4 years	14	14
Duration of admission	Within 1 week	15	15
	1~2 weeks	49	49
	3~4 weeks	8	8
	4~8 weeks	8	8
	> 8 weeks	20	20
Number of admission	1 time	31	31
	2~5 times	33	33
	> 5 times within 1 year	14	14
	≥ 1 year	21	21
Previous experience of Koran medical hospital treatment	Yes	27	27
Previous experience of Koran medical hospital treatment	No	73	73
Total		100	100
Variable		Total
		Number	%
		Past experience of Korean medical hospital	Yes	27	27
No	73		73
Total (missing)	100 (0)		100
Satisfaction of past experience of Korean medical hospital	Very satisfied	8	29.6
	Satisfied	11	40.7
	Neutral	8	29.6
	Dissatisfied	0	0
	Very dissatisfied	0	0
	Total (missing)	27 (73)	100
The route that led to the choice of Korean medical hospital	Reporting on TV, newspapers, the Internet, etc.	11	11.8
	Seeing review of others on website or etc.	2	2.2
	Recommendations from others	61	65.6
	Search by oneself	18	19..4
	Etc.	1	1.1
	Total (missing)	93 (7)	100
Willingness to recommend to others	Yes	97	97
	No	0	0
	Don’t know	3	3
	Total (missing)	100 (0)	100
Variable		Total
		Number	%
		General satisfaction of medical service	Very satisfied	43	43
Satisfied	48		48
Neutral	9		9
Dissatisfied	0		0
Very dissatisfied	0		0
Total (missing)	100 (0)		100
Satisfaction of treatment cost	Very satisfied	21	21.6
	Satisfied	38	39.2
	Neutral	33	34.0
	Dissatisfied	3	3.1
	Very dissatisfied	2	2.1
	Total (missing)	97 (3)	100
Intention to reuse	Yes	97	97
	No	1	1
	Don’t know	2	2
	Total (missing)	100 (0)	100
Intention to visit outpatient after discharge	Yes	79	80.6
	No	1	1.0
	Don’t know	18	18.4
	Total (missing)	98 (2)	100

Treatment item	Number of respondents	%
Acupucture	61	71.8
Pharmacoacupuncture	3	3.5
Cupping	6	7.1
Moxibustion	24	28.2
Herbal medicine	13	15.3
Physical therapy	3	3.5
Manual therapy	14	16.5
Total (No response) / Percentage in case	85 (15)	100

Item description	Number	Mean (SD)
Knowledge and skill of doctor	100	4.72 (0.55)
Feedback from patients	100	4.85 (0.44)
Response and sufficient explanation for usual questions	100	4.86 (0.38)
Sufficient explanation for treatment, prognosis	100	4.78 (0.52)
Total	100	4.80 (0.40)

Item description	Number	Mean (SD)
Accessibility to doctor	100	4.69 (0.56)
Reasonable waiting time	100	4.62 (0.55)
Speed of staff service	100	4.63 (0.60)
Convenience of reception	100	4.78 (0.46)
Post reception waiting time	100	4.66 (0.57)
Total	100	4.68 (0.44)

Item description	Number of respondents	%
For treating cancer only with Korean medicine	3	3
For symptom management	32	32.3
For preventing metastasis or recurrence	35	35.4
For enhancing cancer-related immune system or reducing adverse events after chemotherapy	43	43.4
Total (No response) / Percent in case	99 (1)	100

Item description	Number of respondents	Mean (SD)
Because the skills of the medical staff were excellent	96	4.39 (0.81)
Because hospital’s facilities and equipment are satisfactory	95	4.01 (0.92)
Because academic research and drug development are being actively carried out as university hospital	99	4.14 (0.87)
Because the hospital staff are kind	97	4.37 (0.82)
Because the cost of treatment is cheap	92	2.76 (1.05)
Because it is easy to access or transportation is convenient	95	3.78 (1.20)
Because the hospital staff are well aware of the patient’s information because of previous visits	88	3.41 (1.30)
Total	100

Division		Number	Mean	SD	t score	DF	p-value
Satisfaction degree of doctor service	Male	26	4.89	0.24	1.806	80.826	0.075
Satisfaction degree of doctor service	Female	74	4.77	0.44	1.806	80.826	0.075
Satisfaction degree of using procedure	Male	26	4.82	0.29	2.509	72.105	0.007
Satisfaction degree of using procedure	Female	74	4.62	0.47	2.509	72.105	0.007

Division		Number	Mean	SD	F-statistics	p-value
Satisfaction degree of doctor service	< 40	1	5.00	0.00	0.526	0.717
	40~49	23	4.85	0.27
	50~59	47	4.76	0.50
	60~69	23	4.80	0.29
	≥ 70	6	4.96	0.10
Satisfaction degree of using procedure	< 40	1	4.20	0.00	1.411	0.236
	40~49	23	4.80	0.34
	50~59	47	4.63	0.47
	60~69	23	4.62	0.49
	≥ 70	6	4.90	0.24

Division		Number	Mean	SD	F-statistics	p-value
Satisfaction degree of doctor service	Inoccupation	8	4.91	0.19	0.836	0.545
	Housewife	46	4.80	0.34
	Self employment or Service	15	4.67	0.58
	Student or etc.	5	5.00	0.00
	Office worker	15	4.83	0.29
	Engineer	8	5.00	0.00
	Professional	5	4.69	0.70
Satisfaction degree of using procedure	Inoccupation	8	4.83	0.33	0.935	0.474
	Housewife	46	4.61	0.51
	Self employment or Service	15	4.56	0.45
	Student or etc.	15	4.88	0.27
	Office worker	3	4.73	0.36
	Engineer	8	4.93	0.12
	Professional	5	4.78	0.36