数字化转型背景下老年慢病患者就诊需求及其影响因素研究

Study on the Demands and Influencing Factors of Medical Treatment of The Elderly Patients with Chronic Diseases under the Background of Digital Transformation

目的:调查老年慢病患者的数字化就诊需求状况并分析影响因素,为各级医院制定更为合理有效的数字化就诊管理方案,满足患者就诊需求提供数据支撑。方法:2021~2022年采用自制的慢病老年人数字化就诊需求调查表对京津冀18所医院的630名住院老年慢病患者进行调查,数据进行SPSS 22.0的单因素t检验、方差分析和多因素回归分析,进行AMOS 26.0的结构方程分析。结果:老年慢病患者数字化就诊需求总评分为29.20±7.691,中高需求率在80%以上,其中在线预约挂号和获取电子版就诊档案的高需求率为36.8%和32.9%;单因素和多因素分析显示文化程度、婚姻、失能、经济收入能否支持数字化就医、子女对数字化就医支持、受他人对数字化就医评价影响、医院数字化平台功能等是慢病老年人数字化就诊需求的影响因素;结构方程模型的影响路径分析显示:子女就医支持照顾、医院数字化平台功能直接影响就诊需求,失能、受他人就医评价影响通过子女就医支持间接影响就诊需求,经济收入除直接效应外,也通过医院数字化平台功能间接影响就诊需求。结论:目前老年慢病患者数字化就诊需求较高,受个人、家庭和医院三方面因素影响,提示各级医院数字化就医服务管理和功能应考虑老年人的就医特征、家庭成员的正面宣传和医院数字化平台的持续性改进,以满足患者就诊需要,提升利用力度。

Objective To investigate the status of digital treatment needs of elderly patients with chronic diseases and analyze its influencing factors,so as to establish a more reasonable and effective digital treatment management plan for hospitals and pro⁃vide data support to meet the patients’needs.Methods From 2021 to 2022,630 hospitalized elderly patients with chronic diseases from 18 hospitals in Beijing,Tianjin and Hebei were investigated by a self-made questionnaire on the need for digital treatment of elderly patients with chronic diseases.Data were analyzed by univariate t-test,analysis of variance and multivariate regression a⁃nalysis of SPSS 22.0.And the structural equation analysis of AMOS 26.0 was performed.Results The total score of digital treat⁃ment needs of the elderly patients with chronic diseases was 29.20±7.691,with a medium to high demand rate of more than 80%,in which the high demand rate of online appointment registration and obtaining electronic version treatment files was 36.8%and 32.9%,respectively.Univariate and multivariate analysis showed that education level,marriage,disability,supporting from economic income,children's support for digital medical treatment,affecting by others'evaluation of digital medical treatment,and hospital digital platform function were the influencing factors of digital treatment needs of elderly patients with chronic diseases.Path analysis of structural equation model showed that children's medical support care,hospital digital platform function directly af⁃fected the treatment needs,while disability,affecting by others'evaluation of medical treatment indirectly affected the treatment needs through children's medical support,and economic income indirectly affected the treatment needs through hospital digital plat⁃form function in addition to direct effects.Conclusion At present,the demand for digital medical treatment for elderly patients with chronic diseases is high,which is affected by three factors of individual,family and hospital.It is suggested that the management and function of hospital digital medical service should consider the characteristics of medical treatment for the elderly,positive publicity from family members and continuous improvement of digital platform in hospitals,so as to meet the needs of patients and improve the utilization.