对住院病人医疗服务评价及需求的调查分析

Investigation on current status of in-patient medical service and patient requirements

目的考查医院现有服务结构的合理性和病人对医疗服务的需求.方法对作者所在医院19个临床科室年龄15岁以上的130名病人进行问卷调查,医疗服务评价内容包括:(1)医院饮食、卫生状况;(2)收费合理性;(3)收费透明度;(4)病人总体满意度.医疗服务需求包括:(1)出院后服务;(2)药物类型;(3)病房类型;(4)收费透明度;(5)知情选择.结果 (1)医疗服务评价:87.4%病人对卫生状况满意,51.3%病人对饮食满意;51.3%病人认为收费合理,6.7%病人认为收费不合理;37.2%病人认为收费透明度高,8.3%病人认为收费透明度低,大部分病人希望住院部每3～5 d给一次费用报告单;82.8%病人对医疗服务感到满意.表明医疗服务的综合质量虽然得到了病人的普遍赞同,但在饮食服务、收费透明度和收费合理性方面仍有待提高.(2)医疗服务需求:91.3%病人希望出院后一定时间内可免费看门诊或可通过电话向主管医生咨询有关疾病防治、保健等问题;73.8%病人希望用合资企业生产的或国产药物,26.2%病人喜欢用进口药,仅11.3%病人认为药物越贵治疗效果越好;喜欢住50～70元双人间的病人占40.8%,愿意住30～50元多人间和90～120元单人间的病人比例分别为35.9%、23.3%;调查人群人住单人间、双人间与多人间的比例为2:39:59,病人需求的理想病房结构是36:41:23,矛盾突出表现在单人间设置得太少.93.2%病人希望拥有知情选择权,但仅约半数的病人反映医生在开处方时告之疗效及副作用并尊重病人的选择,而回答医生通常能告之价格的病人不到1/3,表明医生在知情选择方面做得不够,与病人的需求之间存在着显著矛盾.结论联合分析结果表明,提供出院后服务在5个研究因素中的相对重要性最大,对病人评价整个医疗服务的影响最大.

Objective To conduct an investigation on ctirrent medical service for the in-patients in Zhujiang Hospital and tounderstand the requirement of the patients for the services. Methods A questionnaire was designed for that ptirpose to con-duct the investigation in 130 in-patients from 19 clinical departments. Results and conclusion With the current medical ser-vice provided by the hospital, 87.4% of the patients expressed their satisfaction with the sanitahon. 51 .3% with the food and51.3% considered the charges reasonable (to which 6.7% of patients disagreed and 8.3% wished to know the details of thecosts from a report every 3 to 5 d). A total of 82.8% of the patients were satisfied with the medical care. As for the require-ments and expectations of the medical service, 91 .3% of the paticnts wished to have free rechecks and consultation within cer-tain period after discharge. A proportion of 73.8% of the pahents preferred domestically manufacford drugs or those byjoint-ventufe companies, and 11.3% correlated the price of the drugs with their effects. The results also showed the shortage ofsingle ward. As many as 93.2% of the patients wished to choose between altematives on a basis of thorough knowledge con-ceming their treatrnent but only half of the patients recognized the fulfillment of this rigth The results of multiple analysis showthat the service after discharge is of great importance in affecting the patients' satisfaction with the general medical service.