三级综合医院预出院服务模式的实践与效果

Practice and effect of pre-discharge service mode in the tertiary general hospital

目的 探讨新医改背景下预出院服务模式的实施效果.方法 采取分层抽样的方法在全院53个病区中抽取9个科室作为试点,试点时间为3个月.于实施预出院服务模式前和实施3个月后抽取某一周出院后结算完毕的患者（或家属）,实施前99例和实施后94例.对两组患者的出院过程服务满意度、出院总耗费时间、出院资料齐全率、出院退药人次方面进行比较.结果 试点科室实施预出院服务模式前后患者对出院过程服务满意率分别为55.3％和92.7％,出院总耗费时间为（110.8±7.6）min和（9.6±0.35）min,出院资料齐全率为45.6％和97.5％,出院退药率为31.3％和6.4％,实施前后比较差异具有统计学意义（x2值分别为33.948,64.323,19.339;t=18.572;P ＜0.0l）.结论 预出院服务模式有利于提高患者满意度,缩短出院时间,降低出院退药率,是改善患者就医体验的有效方法,值得推广使用.

Objective To explore the effect of pre-discharge service mode against the background of new medical reform.Methods Nine departments of 58 wards were as a pilot according to stratified sampling method,and the time of the study was three months.The patients before （n =99） and after the implementation （n =94） were respectively chosen from the patients or families with finishing settlement at one week after the discharge before and three months after the implementation of pre-discharge service mode.The satisfaction of discharge process service,the total time of discharge,the complete rate of data on discharge and the number of returning drug were compared in two groups.Results The satisfaction of discharge process service,the total time of discharge,the complete rate of data on discharge and the rate of returning drug were respectively 55.3 %,（110.8± 7.6） min,45.6% and 31.3 % before the implementation of pre-discharge service mode,and were 92.7%,（9.6 ±0.35） min,97.5% and 6.4% three months after the implementation,and the differences were statistically significant （x2 =33.948,64.323,19.339,respectively; t =18.572; P 〈 0.01）.Conclusions Pre-discharge service mode can help improve the patients＆#39;satisfaction,shorten the time of discharge,reduce the rate of returning drug at the time of discharge,is an effective method of improving the patients＆#39; medical experience,and is worthy of clinical promotion.