患者对县级公立医院远程会诊效果满意服务状况分析

骆书秀　吴显儒　凌政　陈斌　卢红平　庞勇

[摘要] 目的 了解患者對县级公立医院远程会诊效果满意服务情况及其影响因素。方法 选择2017年1月—2018年10月在北流市人民医院接受远程会诊且自愿参加的门诊住院患者206例。自行调查调查问卷，问卷内容包括患者人口学特征、会诊前后诊疗效果满意、对会诊中心环境设备和工作人员服务的满意、会诊后对行为意向等。以及分析影响诊疗效果满意度的因素。结果 患者会诊后诊疗效果满意度（89.50%）高于会诊前（78.00%）且差异有统计学意义（χ2=4.519，P<0.05）;对会诊中心环境设备和工作人员服务满意度为95.50%以上;会诊后第14天回访;患者推荐远程会诊服务给亲友和再就医均占99.00%。患者的家庭月收入、付费类别是影响会诊诊疗效果满意的主要因素。结论 县级公立医院患者对远程会诊诊疗效果满意，行为意向较好，患者愿意留在属地医院就医，能实现医改“进一步改善医疗服务行动计划”中以患者为中心，改善患者就医感受的目的。

[关键词] 县级公立医院;远程会诊;效果;影响因素;患者满意度

[中图分类号] R197.3 [文献标识码] A [文章编号] 1672-5654（2020）05（b）-0177-04

Analysis of Patient Satisfaction with Remote Consultation Results of County-level Public Hospitals

LUO Shu-xiu1， WU Xian-ru3， LING Zheng2， CHEN Bin3， LU Hong-ping4， PANG Yong5

1.Department of Science and Education， Beiliu People's Hospital， Beiliu， Guangxi， 537400 China; 2.Department of Beiliu People's Hospital， Beiliu， Guangxi， 537400 China; 3.Department of Neurology， Beiliu People's Hospital， Beiliu， Guangxi， 537400 China; 5.Department of Rehabilitation， Beiliu People's Hospital， Beiliu， Guangxi， 537400 China

[Abstract] Objective To understand the patients' satisfaction with remote consultation results in county-level public hospitals and their influencing factors. Methods 206 outpatients/inpatients who received remote consultations at Beiliu People's Hospital and participated in the survey voluntarily from January 2017 to October 2018 were selected. The questionnaires were self-investigated. The contents of the questionnaire included the demographic characteristics of the patients， satisfaction with the results of the consultation before and after the consultation， satisfaction with the environmental equipment and staff services of the consultation center， and behavioral intentions after the consultation. And analyze the factors that affect the satisfaction of diagnosis and treatment. Results The satisfaction of patients after consultation （89.50%） was higher than that before consultation （78.00%） and the difference was statistically significant（χ2=4.519， P<0.05）; the satisfaction with the environmental equipment and staff service of the consultation center was more than 95.50%; after consultation， on the 14th day， the patients returned to visit; patients recommended remote consultation services to relatives and friends and re-see doctors for 99.00%. The monthly family income and payment category of patients are the main factors that affect the satisfaction of consultation and treatment. Conclusion Patients at county-level public hospitals are satisfied with the effect of remote consultation and treatment， and their behavioral intentions are good. Patients are willing to stay in the local hospital for medical treatment.

[Key words] County-level public hospitals; Remote consultation; Results; Influencing factors; Satisfaction of patiens

随着“健康中国”和“进一步改善医疗服务行动计划”等国家卫生政策的出台，以患者为中心，优化服务流程，改善患者就医感受，是医改的目的和方向。有学者研究发现[1]优化流程能提高患者的服务满意度，而远程会诊是新型就医优化流程的一种服务模式[2]，这种模式能使患者打破医患之间的距离和时间限制，节省患者去大医院往返时间和来回周折的费用，获得优质的服务资源，但服务质量如何是患者需自身体验而感知，但患者就医感知是患者在就医过程中所形成的患者就医期望与实际医疗服务之间的效果[3]。当前信息技术虽然发达，但远程会诊对县级医院的患者来说也是新鲜事物，有研究发现远程会诊的使用在群众中未形成共识[4]，特别在县级医院。有学者[5]认为满意度是从患者对所在医院整体服务的评估、对接受治疗的满意状况和乐意向别人推荐该医院等3个方面来衡量的。……