论文部分内容阅读
目的 研究一、二级医院门诊医疗服务过程质量、就诊时间和医疗费用,为改善医疗服务过程质量提供科学的决策依据。方法 采用模拟患者调查、门诊患者调查、门诊医生调查方法,对上海市区各20家一、二级医院的门诊医疗服务过程质量(包括病史采集、体格检查、实验室检查与辅助检查、诊断、处理、与患者的沟通能力和病史书写总体质量)、就诊时间、医疗费用和患者满意率进行评价。结果 一、二级医院门诊患者对门诊医生医疗服务过程质量的总体满意率为88.5％;模拟患者对门诊医生的医疗服务过程质量的评价总平均分为(67.4±6.8)分(满分100分),门诊医生对自我总体医疗服务过程质量满意者占83.1％,一、二级医院间差异无显著性(P>0.05);除诊疗时间外,一级医院门诊患者的人均挂号与候诊时间、人均付费与配药时间和人均就诊总时间均明显少于二级医院(均P<0.01);门诊患者的药费、实验室检查费、辅助检查费及诊疗总费用及模拟患者的人均门诊诊疗总费用在一、二级医院间差异无显著性(均P>0.05)。结论 一、二级医院门诊医生的医疗服务过程质量基本得到患者的肯定;总体上说,门诊患者就诊挂号与等待时间长、付费时间长、取药时间长、诊疗时间短的现象得到改善;一级医院的医生能够提供与二级医院基本无差异的常见病医疗保健服
Objective To study the quality of outpatient medical service in primary and secondary hospitals, the time of visiting medical service and medical expenses, and to provide scientific decision-making basis for improving the quality of medical service. Methods The quality of outpatient medical service (including history collection, physical examination, laboratory examination and auxiliary examination, diagnosis, diagnosis and treatment of outpatient medical service in 20 primary and secondary hospitals in Shanghai area was analyzed by using simulated patient survey, outpatient survey and outpatient doctor survey method. Treatment, communication with patients, and overall quality of history writing), visit time, medical costs, and patient satisfaction rates. Results The overall satisfaction rate of outpatients with secondary hospitals to outpatients was 88.5%. The overall average evaluation of the quality of outpatients’ medical services was (67.4 ± 6.8) points (out of 100) , Outpatient doctors were 83.1% satisfied with the quality of the overall self-service medical service, and there was no significant difference between the first and second-grade hospitals (P> 0.05). In addition to the treatment time, the average outpatient waiting time and waiting time of outpatients in the first- The total time for payment and dispensing, and the total time for per capita treatment were significantly less than those for the second-grade hospitals (all P <0.01); the out-patient costs of medicines, laboratory tests, auxiliary examinations and the total cost of outpatient visits and outpatient services per person There was no significant difference between primary and secondary hospitals (all P> 0.05). Conclusions The quality of the medical service process of outpatients in primary and secondary hospitals was basically affirmed by patients. Generally speaking, outpatients had long service time, prolonged medication time and short treatment time, Doctors at a hospital can provide common-disease health care that is virtually indistinguishable from a second-level hospital