医务社会工作服务包对全科门诊就诊效率和服务满意度的影响

Impact of medical social work service package on service efficiency and patient satisfaction in general practice outpatient service

目的探讨医务社会工作者介入全科门诊对患者就诊效率及患者和医生满意度的影响。方法采用随机对照干预实验法，于2017年6月依据随机数字表抽取山医大医院全科门诊患者330例进行服务包干预实验，分为实验组（159例）和对照组（163例）。服务包干预内容包括：建议指导服务、咨询服务、陪伴服务、疏导安慰服务、干预指导类服务等。比较两组患者的平均就诊时间、患者满意度以及医生访谈评估医务社会工作者介入的有效性。结果两组患者在性别、年龄、职业、缴费类别上差异均无统计学意义（P〉0.05），具有可比性。实验组患者就诊时间为18（15，22） min，对照组为21（15，25） min，两组比较差异有统计学意义（Z＝2.364，P＝0.018）。对照组满意度最高的是医生工作态度条目（36/40, 90.0%），满意度最低的是诊室环境条目（20/40，50.0%）。实验组满意度最高的是与医生相处的舒适度条目（40/40, 100.0%），其次是医务社会工作者亲和力条目（38/40, 95.0%），最低的是诊室环境条目（32/40, 80.0%）。与医生相处舒适度、诊室环境和诊疗过程这3个条目，实验组满意度[（40/40，100.0%）、（32/40，80.0%）、（37/40，92.5%）]较对照组[（29/40，72.5%）、（20/40，50.0%）、（30/40，75.0%）]明显提高（χ2＝12.754、7.912、4.501，均P〈0.05）。结论医务社会工作者的干预提升了全科门诊就诊效率，建议医务社会工作者在全科团队中开展辅助医疗工作，以最有效的方式实现医疗资源的合理运用。

To evaluate the effects of medical social workers on the service efficiency and patient satisfaction in general practice outpatient service.MethodsA randomized controlled intervention study was conducted at general practice department of Shanxi Dayi Hospital in June 2017. Three hundred and thirty patients were randomly selected and assigned into two groups： 159 patients received intervention with medical social work service package （intervention group） and 163 patients served as controls. The service package included advising service, counseling service, accompanying service, comfort service, intervention guidance service, etc. The average time per visit and patient satisfaction were compared between two groups and the effectiveness of intervention was evaluated by interview of doctors.ResultsThere were no statistically significant differences in gender, age, occupation and insurance categories between the two groups （P〉0.05）. The average time per visit patients in the intervention and control groups were 18 （15, 22） min and 21 （15, 25） min, respectively （Z=2.364, P=0.018）. The highest degree of patient satisfaction in the control group was the attitude of doctors （36/40, 90.0%）, and the lowest was in the setting of consulting room （20/40, 50.0%）. The highest degree of satisfaction in the intervention group was the ＂comfortable with doctors＂ （40/40, 100.0%）, followed by the affinity nature of social workers （38/40, 95.0%）, and the lowest was the environmental satisfaction index （32/40, 80.0%）. The satisfaction of comfortableness with doctors, clinic environment and consultation process in intervention group [（40/40, 100.0%）、（32/40, 80.0%）、（37/40, 92.5%）] was higher than that in control group [（29/40, 72.5%）、（20/40, 50.0%）、（30/40, 75.0%）] （χ2=12.754, 7.912, 4.501, P〈0.05）.ConclusionIntervention provided by medical social workers can improve the efficiency of general practice outpatient service and improve the satisfaction of patients.