儿童家长接受预防接种服务额外消耗时间对总体满意率的影响

Impact of additional time spent for vaccination services on overall satisfaction rate in parents

目的:了解儿童家长对预防接种服务的总体满意率,以及接受预防接种服务额外消耗时间对其满意率的影响。方法:2019年12月至2020年1月,对0~3岁儿童家长基本情况、接受预防接种服务额外消耗时间以及对预防接种服务的总体满意情况进行问卷调查。共3178名儿童家长纳入分析。采用二分类logistic回归模型和限制性立方样条模型分析儿童家长接受预防接种服务额外消耗时间对总体满意率的影响。结果:儿童家长对预防接种服务的总体满意率为92.32%。儿童家长从家到预防接种门诊时间M(P 25,P 75)为10.00(10.00,20.00)min,办理预约登记等候时间M(P 25,P 75)为10.00(5.00,15.00)min,等待进行注射疫苗时间M(P 25,P 75)为5.00(3.00,10.00)min,额外消耗总时间M(P 25,P 75)为30.00(20.00,45.00)min。二分类logistic回归分析结果显示,调整相关因素后,有利于提高儿童家长总体满意率的额外消耗时间因素依次为办理预约登记等候时间(4~min组与8~min组相比,OR=1.863,95%CI:1.307~2.657)、等待进行注射疫苗时间(<4、4~min组与8~min组相比,OR=1.529,95%CI:1.102~2.120;OR=1.534,95%CI:1.104~2.130)、额外消耗总时间(15~min组与30~min组相比:OR=1.470,95%CI:1.094~1.976)。限制性立方样条模型分析显示,儿童家长办理预约登记等候时间(非线性检验χ^(2)=13.18,P=0.001)、等待进行注射疫苗时间(非线性检验χ^(2)=13.50,P=0.001)以及额外消耗总时间(非线性检验χ^(2)=9.38,P=0.009)与总体满意情况的关联强度呈非线性的倒“V”形剂量反应关系。结论:儿童家长办理预约登记等待时间、等待进行注射疫苗的时间和接受预防接种服务额外消耗总时间影响总体满意率。其中,办理预约登记等待时间的影响最大,且该环节等待时间较长,建议预防接种门诊利用信息化技术(如建立微信公众号、APP等)开展分时段预约,并控制单位时间服务人数,对预防接种人群进行有效分流。

Objective To understand the overall satisfaction rate with vaccination services in parents of children,and the impact of additional time consumed for vaccination service on overall satisfaction rate.Methods From December 2019 to January 2020,a total of 3178 parents of 0-3 years old children were investigated to collect the information about their basic characteristics,additional time spent for vaccination service and overall satisfaction through questionnaires.Binary logistic regression model and restricted cubic spline model were used to evaluate the impact of additional time spend on the overall satisfaction rate.Results The overall satisfaction rate of parents with vaccination services was 92.32%.The median time for parents to move from home to vaccination clinic was 10.00(10.00,20.00)minutes,the median waiting time to make an appointment was 10.00(5.00,15.00)minutes,the median waiting time for vaccination was 5.00(3.00,10.00)minutes,and the median total additional time spent was 30.00(20.00,45.00)minutes.The binary logistic regression analysis showed that after adjusting the relevant factors,the main factors affecting the overall satisfaction rate were the waiting time for making an appointment(the 4-minutes group vs.8-minutes group:OR=1.863,95%CI:1.307-2.657),waiting time for vaccination(the<4 minutes group vs.8-minutes group:OR=1.529,95%CI:1.102-2.120;the 4-minutes group vs.8-minutes group:OR=1.534,95%CI:1.104-2.130),total additional time spent(the 15-minutes group vs.30-minutes group:OR=1.470,95%CI:1.094-1.976).Restricted cubic spline analysis showed that the waiting time for making an appointment(non-linear:χ2=13.18,P=0.001),the waiting time for vaccination(non-linear:χ2=13.50,P=0.001),and the total additional time consumed(non-linear:χ2=9.38,P=0.009)showed a non-linear inverted"V"dose response relationship to the overall satisfaction of vaccination services.Conclusions The waiting time for parents to make an appointment,the waiting time for vaccination and the total additional time spent for receiving vaccination services affected the overall satisfaction rate of the vaccination services.And the waiting time for making an appointment was the most important factor,and it is necessary to shorten the waiting time for appointment.It is suggested that the vaccination clinic should make use of information technology(such as WeChat public account,APP)to make accurate appointments,make appointments to the time period to control the number of people within time period.