基于元人种志和DEMATEL-ISM的在线医疗患者满意度关键影响因素研究  

Research on key influencing factors of online medical patient satisfaction based on meta-ethnography and DEMATEL-ISM

作　　者：张利江[1] 夏晶晶 田梅[1] 冯占春[2] 任文杰 Zhang Lijiang;Xia Jingjing;Tian Mei;Feng Zhanchun;Ren Wenjie(School of Health Management,Xinxiang Medical University,Xinxiang 453003,China;School of Medicine and Health Management,Tongji Medical College of Huazhong University of Science and Technology,Wuhan 430030,China;Institute of Health Central Plains,Xinxiang Medical University,Xinxiang 453003,China)

机构地区：[1]新乡医学院卫生健康管理学院,新乡453003 [2]华中科技大学同济医学院医药卫生管理学院,武汉430030 [3]新乡医学院健康中原研究院,新乡453003

出　　处：《中华医院管理杂志》2024年第11期844-850,共7页Chinese Journal of Hospital Administration

基　　金：国家社会科学基金(21BTQ063);河南省哲学社会科学规划年度项目(2020BZH004)。

摘　　要：目的识别和分析在线医疗患者满意度的关键影响因素,为提高在线医疗患者满意度提供参考。方法将"用户满意度、患者满意度"分别与"互联网医疗、在线医疗"等关键词进行组配,在中国知网(CNKI)、中华医学期刊全文数据库等检索2013—2023年发表的文献,基于关键质量评估技能项目筛选原则筛选文献,采用元人种志方法对纳入研究的在线医疗患者满意度影响因素进行综合集成,通过决策实验与评价实验室法(DEMATEL)识别其中的关键影响因素,然后通过解析结构模型法(ISM)方法构建多级递阶结构模型,分析影响因素间的逻辑联系和层级结构,并获得关键影响路径。结果纳入20篇文献进行分析,通过元人种志方法获得个人、社会和技术3个主题维度的影响因素集,包括感知风险、感知质量、信息支持、社交支持、环境支持、情感支持、医疗技术和平台设计8个影响因素。通过DEMATEL-ISM方法确定信息支持和感知质量为关键结果因素,其中心度分别为15.713和15.417,原因度分别为-0.957和-1.095;医疗技术为关键原因因素,中心度为15.476,原因度为0.956;平台设计-医疗技术-社交支持-信息支持为关键影响路径,其中心度之和为59.305。结论本研究获得了在线医疗患者满意度的关键结果因素、关键原因因素及关键影响路径,基于此建议通过提高在线医疗平台的健康信息质量等增强信息支持,通过优化医患交互模式、提高医患沟通效率和响应速度、加强对诊疗过程的监管等提升患者感知质量,通过建立互联网医生能力评价指标体系和强化培训等以提升在线医疗技术水平,通过协同多方利益主体共同促进在线医疗患者满意度的提升。Objective To identify and analyze the key factors affecting online medical patient satisfaction,providing references for improving online patient satisfaction.Methods Matched"user satisfaction,patient satisfaction"with keywords such as"internet medical,online medical",and searched for literature published from 2013 to 2023 in databases like CNKI and the Full-text Database of Chinese Medical Journals.Based on the critical appraisal skills programme for quality assessment,screened the literature.Employed the meta-ethnography method to synthesize the factors affecting online medical patient satisfaction in the included studies.Identified key influencing factors through the decision making trial and evaluation laboratory(DEMATEL)method,and then constructed a multi-level cascading structure model using the interpretative structural modelling(ISM)method to analyze the logical connections and hierarchical structure among the influencing factors,and obtained the key influencing paths.Results 20 articles were included,and through the meta-ethnography method,obtained a set of influencing factors for three thematic dimensions:personal,social,and technological,including eight influencing factors:perceived risk,perceived quality,information support,social support,environmental support,emotional support,medical technology,and platform design.By employing the DEMATEL-ISM method,information support and perceived quality were identified as key outcome factors,with centrality values of 15.713 and 15.417,respectively,and reason degrees of-0.957 and-1.095,respectively.Medical technology was identified as a key cause factor,with a centrality value of 15.476 and a reason degree of 0.956;the key influence path was platform design-medical technology-social support-information support,with a sum of centrality values totaling 59.305.Conclusions This study identified key outcome factors,key cause factors,and key influence paths for online medical patient satisfaction.Based on these findings,it is suggested to enhance information support by

关 键 词：卫生服务管理 患者满意度 在线医疗平台 元人种志 决策实验与评价实验室法-解析结构模型法 影响因素 

分 类 号：R47[医药卫生—护理学]