中国全科医学2018，Vol.21Issue(7)：778-783,6.DOI:10.3969/j.issn.1007-9572.2018.07.006
综合性三级甲等医院全科和专科门诊患者就诊体验及影响因素比较研究
Experience and Influencing Factors of Consultation among Primary Care Outpatients versus Specialty Care Outpatients from the Grade A Tertiary General Hospital
摘要
Abstract
Objective To study the consultation experience and influencing factors of primary care outpatients versus specialty care outpatients from a grade A tertiary general hospital, and based on this, to investigate the role of general practice department of grade A tertiary hospital in the implementation of hierarchical medical system. Methods In March 2017, 200 outpatients from the General Practice Department, West China Hospital, Sichuan University and other 200 outpatients from specialist departments (Department of Endocrinology, Department of Rheumatology and Immunology, Department of Cardiology, etc) of this hospital were recruited and surveyed by self-developed Consultation Experience of Primary Care Outpatients Questionnaire, Consultation Experience of Specialty Care Outpatients Questionnaire, respectively, for obtaining their sociodemographic characteristics, status and thoughts about the consultation. Totaled 185 primary care outpatients and 168 specialty care outpatients handed in responsive questionnaires, with a response rate of 92.5%, 84.0%, respectively. Results Primary outpatient care gained higher overall level of patient satisfaction compared with specialty outpatient care [87.6% (162/185) vs 70.2% (118/168)] (P<0.05). To be specific, primary outpatient care achieved higher patient satisfaction score in the following aspects than specialty outpatient care: duration between appointment and consultation time, consultation length, detail level of the doctor's inquiry, detail level of doctor's explanation of the illness conditions, the doctor consults the next patient although the present one has doubt, degree of protection of patients' privacies, use of personalized treatment regimen, and changes in illness conditions after treatment, but it obtained lower patient satisfaction score in number of consultations (P<0.05). Multivariate Logistic regression analysis showed that consultation length, detail level of the doctor's inquiry, number of consultations, and changes in illness conditions were associated factors for the level of patient satisfaction gained by specialty outpatient care (P<0.05). Conclusion In this grade A tertiary general hospital, compared with specialty outpatient care, primary outpatient care won higher levels of patient satisfaction with the service attitude of healthcare providers as well as doctor-patient communication, which indicates that the role of general practice department in this kind of hospital during the implementation of hierarchical medical system and its cooperation with specialty departments were approved generally. However, the number of primary care revisits was unsatisfactory.关键词
全科医学科/专科/门诊病人/就诊体验/影响因素分析Key words
General practice department/Specialist department/Outpatients/Medical experience/Root cause analysis分类
医药卫生引用本文复制引用
孙俊杰,李双庆..综合性三级甲等医院全科和专科门诊患者就诊体验及影响因素比较研究[J].中国全科医学,2018,21(7):778-783,6.基金项目
四川省科技厅软科学研究计划项目(16RKX0536) （16RKX0536）
