基于Boruta算法的某专科医院门诊患者就诊行为分析  

Analysis on medical visit behaviors of outpatients in a specialized hospital based on Boruta algorithm

作　　者：邵倩[1] 王磊[2] 周耿[3] 李磊 邹慕蓉 郑昊 邵辰杰[4] Shao Qian;Wang Lei;Zhou Geng;Li Lei;Zou Murong;Zheng Hao;Shao Chenjie(Outpatient Department of Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Nanjing 210008,China;Leadership Department of Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Nanjing 210008,China;Business School of Nanjing University,Nanjing 210093,China;Medical department of Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Nanjing 210008,China;Information Section of Nanjing Stomatological Hospital,Affiliated Hospital of Medical School,Institute of Stomatology,Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属口腔医院,南京市口腔医院,南京大学口腔医学研究所门诊部,南京210008 [2]南京大学医学院附属口腔医院,南京市口腔医院,南京大学口腔医学研究所院部,南京210008 [3]南京大学商学院,南京210093 [4]南京大学医学院附属口腔医院,南京市口腔医院,南京大学口腔医学研究所医务处,南京210008 [5]南京大学医学院附属口腔医院,南京市口腔医院,南京大学口腔医学研究所信息科,南京210008

出　　处：《中华医院管理杂志》2024年第6期431-437,共7页Chinese Journal of Hospital Administration

基　　金：江苏省医院协会医院管理创新项目(JSYGY-3-2023-341);南京市卫生科技发展管理A类课题(GAX21283);南京大学中国医院改革发展研究院课题项目和南京鼓楼医院医学发展医疗救助基金会资助项目(NDYG012)。

摘　　要：目的分析三级公立专科医院门诊患者就诊选择偏好,为优化医院门诊医疗资源配置,提升就医体验提供依据。方法采用方便抽样方法,选取2022年1—9月某三级公立口腔医院门诊患者进行问卷调查,问卷内容包括性别、年龄、居住地、受教育程度和就诊需求等。采用Logistic回归模型和Boruta算法分析影响患者首选三级公立专科医院就诊的因素。结果本研究共纳入19255例患者,首选三级公立专科医院就诊的患者13558例(70.41%),其中,21~45岁者9715例(71.65%),本地患者10015例(73.87%),选择治疗类项目者8278例(61.05%),来院就诊原因为医保报销者6442例(47.51%)。经Logistic回归分析,年龄、居住地、受教育程度、就诊需求、口腔保健习惯、口腔保健知识获取途径、互联网医院预问诊经历、月收入、家庭成员数和来院就诊原因是患者首选三级公立专科医院的影响因素;经Boruta算法分析,重要性排名前6位的因素分别为来院就诊原因(Z=126.66)、口腔保健习惯(Z=96.44)、口腔保健知识获取途径(Z=66.91)、就诊需求(Z=62.21)、年龄(Z=57.54)和居住地(Z=55.21)。结论本地患者和中青年患者倾向选择三级公立专科医院就诊,治疗类项目是三级公立专科医院吸引患者的主要业务类型。患者首选三级公立专科医院就诊的影响因素较多,其中来院就诊原因、口腔保健习惯、口腔保健知识获取途径和就诊需求是影响患者就诊行为的重要因素。Objective To analyze the preferences of outpatients in a tertiary public specialized hospital,for references for optimizing the allocation of outpatient medical resources,and enhancing the medical experience.Methods This study used convenience sampling method to select outpatients from a tertiary public stomatological hospital from January to September 2022 as the survey subjects,and conducted a questionnaire survey.The questionnaire mainly included gender,age,place of residence,education level,and medical needs,etc.Logistic regression model and Boruta algorithm were used to analyze the factors influencing patients'preferred tertiary public specialized hospitals for treatment.Results A total of 19255 patients were included in this study.13558 patients(70.41%)preferred tertiary public specialized hospital for treatment,including 9715 patients(71.65%)aged 21 to 45,1015 local patients(73.87%),8278 patients(61.05%)who chose treatment options,and 6442 patients(47.51%)who came to the hospital for medical insurance reimbursement.By logistic regression analysis,age,residence,education level,medical needs,oral health habits,access to oral health knowledge,pre interview experience of Internet hospitals,monthly income,number of family members and reasons for seeking medical treatment were the influencing factors of patients'preference for tertiary public specialized hospitals.According to the Boruta algorithm analysis,the top 6 important factors were the reasons for seeking medical treatment(Z=126.66),oral health habits(Z=96.44),access to oral health knowledge(Z=66.91),medical needs(Z=62.21),age(Z=57.54),and residence(Z=55.21).Conclusions Local patients and young and middle-aged patients tended to choose tertiary public specialized hospitals for treatment,and treatment projects were the main business types that attract patients to visit tertiary public specialized hospitals.There were many important influencing factors for patients choosing tertiary public specialized hospitals for treatment,including the reasons for seekin

关 键 词：门诊患者 就诊偏好 LOGISTIC回归模型 Boruta算法 影响因素 问卷调查 

分 类 号：R197.323[医药卫生—卫生事业管理]