门诊预约诊疗模式在上海市社区卫生服务中心的实施效果分析

Analysis of the effect of the implementation of the outpatient appointment mode in community health service centers in Shanghai

目的:对上海市14家社区卫生服务中心门诊预约诊疗模式的实施效果进行调查分析,为卫生行政部门推行门诊预约诊疗模式提供参考。方法:在上海市静安区、浦东新区和杨浦区选取14家实施门诊预约诊疗模式的社区卫生服务中心,将2020年10—12月(实施门诊预约诊疗模式后)、2019年10—12月(实施门诊预约诊疗模式前)期间在社区卫生服务中心门诊就诊的同一批患者作为调查对象进行问卷调查。于实施门诊预约诊疗模式前后分别对268例患者发放调查问卷,实施前发放问卷268份,回收有效问卷268份,有效回收率100.0%,实施后发放问卷268份,回收有效问卷268份,有效回收率100.0%。结果:实施门诊预约诊疗模式前后,268例患者中有131例的预约方式发生了变化,其中网络预约患者由19例上升至105例,诊间预约患者由11例上升至43例,现场预约患者由212例下降至97例,电话预约患者由26例下降至23例,患者不同预约方式的预约率差异有统计学意义(P<0.001)。实施门诊预约诊疗模式前后,患者就诊平均等候时间、就诊满意率和就诊依从率的差异均有统计学意义(P<0.001)。结论:门诊预约诊疗模式的实施缩短了患者候诊时间、提升了患者就诊满意度,确保了有序就诊环境,优化了疫情防控管理,提升了患者粘合度,为社区卫生服务精细化管理提供了有力保障。

Objective: To investigate and analyze the implementation effect of outpatient appointment mode in 14community health service centers in Shanghai, to provide reference for the health administrative department to implement the outpatient appointment mode. Methods: Fourteen community health service centers implementing the outpatient appointment mode were selected in Jingan District, Pudong New District and Yangpu District of Shanghai, and the same group of patients who visited the outpatient department of the community health service centers from October to December 2020(after the implementation of the outpatient appointment mode) and from October to December 2019(before the implementation of the outpatient appointment mode) were selected as the survey objects to conduct a questionnaire survey. Before and after the implementation of the outpatient appointment mode, questionnaires were distributed to 268 outpatients, respectively, before the implementation 268 questionnaires were distributed, and 268 valid questionnaires were recovered, with an effective recovery rate of 100.0%, after the implementation, 268 questionnaires were distributed, and 268 valid questionnaires were recovered,with an effective recovery rate of 100.0%. Results: Before and after the implementation of the outpatient appointment mode, the appointment methods of 131 of 268 patients changed, of which the number of online appointment patients increased from 19 to 105, the number of inter clinic appointment patients increased from 11 to 43, the number of on-site appointment patients decreased from 212 to 97, and the number of telephone appointment patients decreased from 26 to 23, and there was significant difference in the appointment rate of different appointment methods(P<0.001). There were significant differences in average waiting time, satisfaction rate and compliance rate before and after the implementation of the outpatient appointment mode(P<0.001).Conclusion: Implementation of the outpatient appointment mode shortens the waiting time of patients, improves the satisfaction of patients, ensures an orderly treatment environment, optimizes the epidemic prevention and control management, improves the outpatients compliance, and provides a strong guarantee for the fine management of community health services.