用模拟病人法评价上海一二级医院门诊医疗服务过程质量  

Assessment of the process quality of outpatient services by second and third grade hospitals in Shanghai by means of simulated patients

作　　者：薛迪[1] 李霞[2] 丁瑾瑜[1] 李敏[1] 胡天佐[2] 孙让春[2] 陈洁[3] 

机构地区：[1]上海职工医学院,上海200237 [2]上海市卫生局 [3]上海医科大学

出　　处：《中华医院管理杂志》2000年第4期201-204,共4页Chinese Journal of Hospital Administration

摘　　要：目的　通过评价一二级医院门诊医疗服务过程质量 ,为领导改善门诊质量提供决策依据。方法　采用模拟病人法对上海市区一二级医院各 2 0所门诊医疗服务进行调研。结果　通过模拟病人的 480次调查中 ,对医德的总体满意率为 5 8 75 % ,门诊医德医疗服务过程质量总体评价服从正态分布 ,一级医院平均得分 6 7 38,平均就诊时间和费用分别为 16 6 2分和 132 0 2元 ;二级医院平均得分 6 7 43,平均就诊时间和费用分别为 2 2 38分和 12 4 37元。影响质量的是疾病类型和诊疗时间 ,估计值 (bi)分别为 0 6 36 5、0 2 970。而影响医疗费用的主要是疾病类型 ,估计值 (bi)y - 2 9995。结论　一二级医院门诊医疗服务过程质量基本达到规范化要求 。Objective To provide leaders with decision making basis for improving the quality of outpatient services by assessing the process quality of outpatient services delivered by second and third grade hospitals. Methods A study was conducted of the outpatient services delivered by 20 second grade and 20 third grade hospitals in the urban district of Shanghai by means of simulated patients. Results In the 480 investigations by simulated patients, the total ratio of satisfaction towards medical ethics was 58 75%. The overall assessment of the process quality of outpatient services in medical ethics was in normal distribution, with the average score, consultation time and expenses of second grade hospitals being respectively 67 43, 22 38 minutes and 124 37 yuan and those of the third grade hospitals being respectively 67 38, 16 62 minutes and 132 02 yuan, Quality affecting factors were type of disease and consultation time, with the estimated value being respectively 0 6365 and 0 2970 while the factor affecting medical expenses was chiefly type of disease, with the estimated value being y 2 9995. Conclusion The process quality of outpatient services delivered by second and third grade hospitals accords in the main with the demands of standardization. Further improvement, however, is still needed.

关 键 词：模拟病人法 门诊 服务过程 质量管理 

分 类 号：R197.32[医药卫生—卫生事业管理]