公立医院医生开展互联网医疗服务的偏好研究——基于离散选择实验

Research on the preference of doctors in public hospitals to carry out Internet diagnosis and treatment services:Based on discrete selection experiment

目的:通过调查公立医院医生对开展互联网医疗的选择偏好,探讨影响医生开展互联网医疗的因素,以期为公立互联网医院的运营优化提供参考。方法:基于离散选择实验方法,确定服务时间、服务模式、服务方式、服务项目和服务收费5个属性,采用正交试验设计确定8个选择集。采用网上问卷调查的方式进行数据收集,对得到的数据利用基于Cox比例风险模型参数估计的条件logit回归分析进行统计分析。结果:服务时间上,医生更愿意选择碎片化时间服务;服务方式上,医生更愿意以图文方式开展互联网诊疗;服务项目上,医生更愿意提供线上咨询服务;服务收费上,医生更愿意服务收费为与线下门诊持平或高于线下门诊。结论:建议创新服务模式,合理分配与调度线上线下医生资源;根据互联网医患沟通特点,优化线上诊疗服务方式和服务项目。加快互联网医疗服务价格管理的政策保障体系建设,合理补偿互联网医疗服务成本。

Objective:By investigating preference of doctors in public hospitals in terms of medical treatment online,this paper discusses factors influencing doctors’practice of carrying out medical treatment online so as to provide reference for better operation of online public hospitals.Methods:Based on the discrete selection experiment method,five attributes of service are selected,namely timing,mode,method,items and charge,and eight selection sets are determined through orthogonal experimental design.The data are collected through online questionnaire and analyzed with conditional logit regression analysis based on parameter estimation of cox proportional risk model.Results:In terms of timing of service,doctors prefer fragmented time slots;for means of service,doctors prefer pictures combined with words when conducting online diagnosis and treatment;for items,doctors are more willing to provide online counseling services,in terms of service charges,doctors prefer to charge no less than or higher than offline clinics.Conclusion:A novel mode of service is recommended to rationally allocate online and offline doctor resources;methods and items of online diagnosis and treatment are to be optimized according to characteristics of online communication between doctors and patients.It is suggested that construction of a guarantee system is accelerated to regulate prices of online medical diagnosis and treatment and to reasonably compensate for the cost of online medical services.