“互联网+”全科医疗门诊就诊情况研究

Online Consultation in the Department of General Practice under "Internet+"

目的了解"互联网+"全科医疗门诊就诊情况,为全科医师线上门诊接诊提供借鉴与参考。方法选取2016年2月—2017年2月在浙江大学医学院附属第一医院互联网医院就诊系统内全科医疗门诊就诊的715人次为研究对象。收集患者的基本情况、疾病种类与处理措施,并对愿意参与互联网后台评价系统主观满意度调查的患者进行调查。结果 715人次就诊患者中,疾病所属系统排在前3位的分别为骨骼肌肉系统91人次(12.7%)、消化系统81人次(11.3%)、生殖系统66人次(9.2%);处理措施排在前3位的分别为需线下门诊就诊451人次(63.1%)、给予治疗指导/预约检查181人次(25.3%)、需观察随访74人次(10.3%)。初步诊断确诊疾病563人次(78.7%),未确诊疾病152人次(21.3%);其中,未确诊疾病排在前3位的分别为关节痛待查14人次(9.2%)、腹痛待查13人次(8.6%)、头晕待查13人次(8.6%),确诊疾病排在前3位的分别为皮疹24人次(4.3%)、上呼吸道感染18人次(3.2%)、胃炎14人次(2.5%)。378例接受了满意度调查的患者中,369例(97.6%)对就诊经历满意。结论全科医师线上门诊接诊患者就诊满意度较高,但仍存在一定的局限性,全科医师需进一步提高线上问诊能力。

Objective To explore the status of online visits in the Department of General Practice under ＂Internet＋＂ in order to provide the reference for the improvement of online consultation skills of general practitioners.Methods From February 2016 to February 2017,patients＇ basic characteristics,types of diseases,and treatment measures of 715 online visits were collected from the online Department of General Practice of the First Affiliated Hospital,College of Medicine,Zhejiang University.And patients who were willing to participate in the subjective satisfaction survey of the Internet evaluation system were investigated.Results Of the 715 online outpatient visits,the top three system involved 91（12.7%）visits in the musculoskeletal system,81（11.3%）visits in the digestive system,and 66（9.2%）visits in the reproductive system.The top three treatment measures were offline treatments for 451（63.1%） visits,treatment guidance/examination appointments for 181（25.3%）visits,and follow-up for 74（10.3%）visits.And 563（78.7%）visits were diagnosed with certain diseases,and 152（21.3%）visits were undiagnosed.The top three undiagnosed diseases were joint pain[14（9.2%）],abdominal pain[13（8.6%）],and dizziness[13（8.6%）].The top three diagnosed diseases were rash[24（4.3%）],upper respiratory tract infection [18（3.2%）],and gastritis[14（2.5%）].Of the 378 patients who were surveyed for satisfaction,369（97.6%）were satisfied with their experience.Conclusion Patients have high satisfaction with the online consultation of general practitioners while there are still some limitations,which demands higher online consultation skills of general practitioner.