上海市社区卫生服务中心就诊患者的e-health使用现状调查

Application of e-health among patients visiting community healthcare centers in Shanghai

目的了解上海市社区卫生服务中心就诊患者使用e-health的现状及观点。方法2014年11月从上海市两家社区卫生服务中心各抽取20例就诊患者，进行半开放式、深入定性访谈。根据访谈结果，自制调查问卷，采用横断面调查的方法，2015年3—5月从上海市随机抽取8个区县，且从每区县中各随机抽取一家社区卫生服务中心（共8家），选取上述社区卫生服务中心某日就诊的480例患者进行问卷调查。访谈和问卷调查主要内容包括：就诊患者生活中使用信息与沟通技术（ICT）交流的现状；患者使用ICT与医务人员进行医疗交流的现状；患者对于将ICT应用于医疗咨询中的态度和观点；患者对于e-health发展的观点。结果接受访谈的患者中25.0%（10/40）有使用e-health的经验，问卷调查对象中16.7%（62/371）有使用e-health的经验。使用方式方面，90.3%（335/371）患者采用打电话，16.1%（60/371）采用短信、12.9%（48/371）采用微信。使用原因方面，64.5%（40/62）患者为病情咨询、40.3%（25/62）为药物咨询、24.2%（15/62）为身体出现突发状况求助等。56.3%（209/371）患者认为有必要在社区推广e-health。69.4%（145/209）的患者认为这种医疗咨询方式可以省时、省力，不需要经常去医院。患者未使用或者认为不必要使用e-health的主要原因方面，87.6%（142/162）患者认为距离医院较近、就诊方便。结论目前上海市社区医疗服务中患者对e-health的使用并不普遍，使用的形式及方式也比较单一。超过半数的患者认为有必要使用e-health，但需要对医疗资源进行更合理的分配，以及提高社区卫生服务人员的医疗水平。

ObjectiveTo exmine the status and perspectives of e-health among patients in Shanghai community health center.MethodsIn November 2014, a semi-open and in-depth qualitative interview was conducted among 40 patients from two community health service centers in Shanghai. According to the results of the interview, a self-made questionnaire was designed and a cross-sectional survey was carried out from March 2015 to May 2015. Eight districts or counties of Shanghai were randomly selected, and one community health service center was randomly selected from each district or county. Total 480 patients who visited the selected center participated in the survey. The main contents of the interviews and questionnaires included： the current status of communication using information and communication technologies （ICT） in patient daily life; the status of the communication with medical personnel by using ICT; the attitudes and perspectives of patients in applying ICT for medical service; and views on e-health development.ResultsAmong the participants, 25.0%（10/40） of the interviewees and 16.7%（62/371）of the quesitionnaire surveyees had experience of using e-health. Among the questionaired patients, telephone-call was the most common method for communication with doctors （90.3%, 335/371）, followed by short message （16.1%, 60/371） and wechat （12.9%, 48/371）. Illness consulting is the most common perpurse for communication（64.5%, 40/62）, followed by medicine advice（40.3%, 25/62） and sudden physical help（24.2%, 15/62）. Among the participants, 56.3%（209/371）of whom thought that e-health should be promoted in the community, 69.4% （145/209） of whom thought that it could save time and effort; among the patients not using or considering unnecessary to use e-health, 87.6% （142/162） of whom thought they lived closer to the hospital and easy to access.ConclusionAt present, less patients have the experience of using e-health, but more than half of them believe that it is necessary to use e-health and it should be promoted in the community healthcare.