摘要
背景《卫生部关于在公立医院施行预约诊疗服务工作的意见》(卫医管发﹝2009﹞95号)提出公立医院应实施预约就诊,基层医疗卫生机构也在实施范围内。调查基层医疗卫生机构预约就诊的开展现况,对于优化其诊疗模式具有重要意义。目的了解上海市中心城区社区卫生服务中心预约就诊服务开展现况,为优化基层诊疗模式提供政策建议。方法于2018-08-27至2018-09-11,对上海市黄浦区的所有社区卫生服务中心(共10家)进行调研。采用专题小组访谈的方式,逐家单位进行社区预约就诊实施方案、实施现况及实施效果评价的信息采集,受访者为各社区卫生服务中心的业务分管主任及医务科、信息科、一线医护人员代表4~6名。采用内容分析法,对访谈资料进行编码、归类、精简,形成描述性语言。结果共44名医务人员接受了访谈。10家社区卫生服务中心中,9家开展了预约就诊服务。预约就诊模式可分为无记录预约(3家)、有记录预约且按约定日期就诊(7家)、有记录预约且在约定时间段可优先就诊(5家)3种,多家社区卫生服务中心在不同科室实施不同的预约就诊模式。社区预约就诊门诊量较少,占总门诊量的比重不超过10%;预约就诊患者以老年人为主,就诊目的主要为复诊和配药,预约全专联合门诊的主要就诊目的为获得专科诊疗服务;预约方式主要为现场预约;预约就诊的爽约率总体较低。减少候诊时长或改善就诊环境的预约就诊,可以缓解患者的就诊焦虑;但各类预约就诊模式在平衡医生接诊的高峰期和低谷期方面无明显效果,医生对预约就诊患者的接诊时间也未延长。结论社区卫生服务中心目前在开展的3类预约就诊模式,从无记录到有记录且具体到时间段优先就诊,体现了预约就诊对医患双方诊疗时间分配的精确度和约束力度的加强;且从促进医疗卫生资源合理分配方�
Background Opinions on the Implementation of Appointment Services in Public Hospitals[WYGF(2009)No.95] issued by the original Ministry of Health put forward that public hospitals should be scheduled for appointments,and primary health care institutions are also within the scope of implementation.So analyzing the implementation of appointment services is of great significance for optimizing the diagnosis and treatment model of primary health care institutions.Objective To explore the implementation status of appointment services in community health centers(CHCs) in downtown Shanghai,providing suggestions for optimizing the primary healthcare system.Methods The survey was conducted across all the 10 CHCs located in Huangpu District,Shanghai through August 27 th to September 11 th,2018,with the method of focus group discussion.Participants were directors,and representatives of information department workers,and first-line clinicians and nurses recruited from the CHCs(4-6 cases from each).Information about current implementation of appointment services,including implementation plans,practice and evaluation were collected.Description was formed after coding,classification and condensing with content analysis.Results A total of 44 medical professionals attended.The survey that appointment services had been carried out in 9 CHCs.There were 3 major types of making appointments:making an appointment without medical record(3 CHCs),making an appointment with medical record,and consulting on the appointment date(7 CHCs),making an appointment with medical record,and having priority in consulting during the appointment period(5 CHCs).Multiple CHCs implement different appointment modes in different departments.But only a small percentage of patients made appointments,accounting for less than 10% of the total outpatient visits.The majority of patients who frequently used the appointment system were elderly adults,mainly for regular revisits or prescriptions.Those making an general-specialty appointment were mainly for obtaining
作者
吴舒窈
徐虹霞
何明
陈荔萍
吴鹏亮
WU Shuyao;XU Hongxia;HE Ming;CHEN Liping;WU Pengliang(Department of General Practice,Huangpu District Dapuqiao Community Health Center,Shanghai 200023,China;Huangpu District Health Affairs Management Center,Shanghai 200025,China;Department of Neurology,Ruijin Hospital Luwan Branch,Shanghai Jiao Tong University School of Medicine,Shanghai 200025,China)
出处
《中国全科医学》
CAS
北大核心
2020年第10期1248-1253,共6页
Chinese General Practice
基金
上海青年医生培养资助计划(沪卫计人事[2018]15号)
上海市卫生和计划生育委员会科研课题(20174Y0145)。
关键词
社区卫生服务
社区卫生中心
病人预约和时间安排
候诊时长
定性研究
上海
Community health services
Community health centers
Appointments and schedules
Waiting time
Qualitative research
Shanghai
