基于离散选择实验的公立医院护理人员提供“互联网+护理服务”偏好研究  

Study on the Preference of Nursing Staff in Public Hospitals to Provide"Internet Plus Nursing Services"based on Discrete Choice Experiment

作　　者：刘翠 娄佳奡 张志霞 陈思怡 陈秋霞[3] LIU Cui;LOU Jiaao;ZHANG Zhixia;CHEN Siyi;CHEN Qiuxia(Wuhan University of Science and Technology Medical School,Wuhan,430065,China;不详)

机构地区：[1]武汉科技大学医学院,湖北武汉430065 [2]武汉大学中南医院,湖北武汉430062 [3]武汉科技大学附属天佑医院,湖北武汉430064

出　　处：《中国社会医学杂志》2025年第2期221-225,共5页Chinese Journal of Social Medicine

基　　金：湖北省卫生健康委科研项目(H20220097)。

摘　　要：目的调查公立医院护士提供“互联网+护理服务”的偏好,为促进“互联网+护理服务”的可持续发展提供参考。方法基于离散选择实验方法,编制护士“互联网+护理服务”提供偏好的问卷,对湖北省6所公立医院的护士进行现场问卷调查,运用混合Logit模型分析偏好结果。结果共回收问卷852份,有效问卷770份,有效回收率90.38%。研究纳入的五个属性差异均有统计学意义(P<0.05)。各属性相对重要性大小依次为单次服务费用(37.74%)、激励机制(24.33%)、服务模式(17.90%)、服务平台(13.56%)和服务内容(6.47%);其中,效应最大的属性水平为纳入绩效考核(β=0.53;95%CI:0.41~0.65),职称晋升优先(β=0.49;95%CI:0.38~0.59)、团队上门服务(β=0.44;95%CI:0.37~0.51)位于第二、第三名;相较于无激励机制,护士分别愿意牺牲130.64(95%CI:100.34~160.95)元和120.24(95%CI:91.83~148.65)元的服务费用,来获得纳入绩效考核和职称晋升优先的激励机制;为了获得团队上门服务,护士愿意牺牲107.59(95%CI:87.54~127.64)元的服务费用。结论公立医院护士偏好于提供单次服务费用高、有激励机制及团队上门服务模式的“互联网+护理服务”。建议合理制定上门服务费用分配标准,完善护理队伍激励机制,建立团队上门服务形式,探索多层次服务组合方式,提高服务项目吸引力。Objective This study aims to provide reference for promoting the sustainable development of"Internet plus nursing services"by investigating the preference of nurses in public hospitals for providing"Internet plus nur-sing services".Methods Based on the Discrete Choice Experiment method,a questionnaire on nurses'preference for"Internet plus nursing services"was prepared.A on-site questionnaire survey was conducted among nurses in six public hospitals in Hubei province,and the mixed logit model was used to analyze the preference.Results A total of 852 questionnaires were collected,with 770 valid questionnaires and effective response rate was 90.38%.Five attributes differences were statistically significant(P<0.05).The relative importance of attributes were in order of single ser-vice cost(37.74%),incentive mechanism(24.33%),service mode(17.90%),service platform(13.56%),and service content(6.47%).Among them,the attribute level with the greatest effect was incorporate into performance evaluation(β=0.53;95%CI:0.41-0.65),followed by priority given to professional title promotion(β=0.49;95%CI:0.38-0.59)and team on-site service(β=0.44;95%CI:0.37-0.51).Compared to no incentive mechanism,nurses were willing to sacrifice service fees of 130.64(95%CI:100.34-160.95)yuan and 120.24(95%CI:91.83-148.65)yuan respectively to obtain incentive mechanisms that prioritize performance evaluation and professional title promotion.In order to obtain team on-site service,nurses were willing to sacrifice a service fee of 107.59(95%CI:87.54-127.64)yuan.Conclusion Nurses in public hospitals prefer to provide"Internet plus nursing services"with high single service cost,incentive mechanism and team on-site service mode.It is recommended to establish reasonable allocation standards for on-site service fees,improve the incentive mechanism for nursing teams,establish team on-site service forms,explore multi-level service combination methods,and improve the attractiveness of service projects.

关 键 词：互联网+护理服务 离散选择实验 公立医院 护理人员 偏好 

分 类 号：R192.6[医药卫生—卫生事业管理]