预约诊疗服务视角下综合医院门诊老年患者就医体验现状及影响因素研究

Research on the Current Situation and Influencing Factors of Medical Experience of Elderly Outpatients in General Hospitals from the Perspective of Appointment Diagnosis and Treatment Service

目的在预约诊疗服务背景下,全面了解综合医院门诊老年患者就医体验的具体情况,探讨影响综合医院门诊老年患者就医体验的相关因素。方法于2023年1月-3月,选取云南省昆明市2所三甲综合医院门诊预约诊疗的338名老年患者,使用一般资料问卷、患者就医相关信息问卷和患者体验量表调查其对预约诊疗的体验情况,剖析影响老年患者预约诊疗体验的相关因素。结果被调查的老年患者中会选择网上预约途径就诊的占24.18%,其中有且独立完成预约挂号仅占28.96%;老年患者预约诊疗体验感得分为(82.95±20.51)分,就医体验各维度得分由高到低依次为医疗信息(25.50±6.71)分、医患沟通(21.85±6.21)分、物理环境与便利(19.62±4.67)分、医疗费用(9.65±2.78)分、短期诊疗结果(6.33±1.95)分;相比于农村户口,城镇户口的老年患者预约诊疗体验相对较好;影响老年患者预约诊疗体验的主要因素从大到小依次为年龄、主动学习能力、是否为首诊患者、性别(P<0.05)。结论老年患者预约诊疗相关医疗信息的获取、医患的沟通体验较好,但对于医疗费用咨询、短期诊疗结果回馈服务体验较差。预约诊疗服务平台的发展需结合老年患者特殊的生理和心理实际情况进行简化、易化、适老化,从而在实践中不断提升老年患者预约诊疗的良好体验。

Objective To comprehensively understand the specific situation of elderly outpatients in general hospitals under the background of appointment diagnosis and treatment services,and to explore the relevant factors affecting the medical experience of elderly outpatients in general hospitals.Methods From January to March 2023,338 elderly patients who made outpatient appointments in two tertiary general hospitals in Kunming,Yunnan Province were selected to investigate their experience of appointment diagnosis and treatment using general information questionnaires,patient-related questionnaires and patient experience scales,and the relevant factors affecting the appointment experience of elderly patients were analyzed.Results Among the elderly patients surveyed,24.18%chose online appointment for treatment,of which only 28.96%completed the appointment registration independently.The score of elderly patients'experience of appointment diagnosis and treatment was(82.95±20.51)scores.The scores of each dimension of medical experience from high to low were medical information(25.50±6.71)scores,doctor-patient communication(21.85±6.21)scores,physical environment and convenience(19.62±4.67)scores,medical expenses(9.65±2.78)scores and short-term diagnosis and treatment results(6.33±1.95)scores.Compared with rural hukou,the experience of appointment diagnosis and treatment for elderly patients with urban hukou was relatively better.The main factors affecting the experience of appointment diagnosis and treatment in elderly patients were age,active learning ability,whether it was the firstly-diagnosed patient,and gender(P<0.05).Conclusion Elderly patients have better experience of obtaining medical information related to appointment diagnosis and treatment,and communication between doctors and patients,but have a poor service experience for medical cost consultation and short-term diagnosis and treatment results.The development of the appointment service platform needs to be simplified,facilitated and suitable for aging in combination with the special physiological and psychological conditions of elderly patients,so as to continuously improve the good experience of elderly patients in appointment diagnosis and treatment in practice.