網路門診患者就診體驗及再次就診影響因素之調查分析

Survey of Online Outpatient Clinic Usage Experiences and Analysis of Factors Influencing Retreatment

背景：新冠肺炎疫情下，人們多隔離在家，需要通過網路進行就醫問診，且中國國家政策也提倡發展互聯網醫院。目的：瞭解成都市某三甲醫院網路門診患者就診體驗現狀，分析影響其滿意度及再次就診之因素。方法：採用自製問卷對2019年1–7月在四川省某三級甲等醫院網路門診就診之191例患者進行電訪調查，對所收集資料進行描述性統計及分析其影響因素。結果：網路門診就診患者以中青年（92.7％）、大學及以上教育程度者為主（42.9％）；大部分患者對網路門診表示滿意（72.2％），其中非常滿意者占31.4％；91.1％的患者認為使用網路門診提高了對健康之自我管理意識。191名電訪患者中有176（92.1％）名表示願意再次使用網路門診。認為就診問題不能及時解決（χ2＝8.603, p＝.045）、網路掛號流程繁瑣（χ2＝8.322, p＝.016）、不能現場身體檢查（χ2＝8.958,p＝.015）以及就診品質不可靠（χ2＝15.373, p＝.004）是影響患者再次使用網路門診之主要因素。結論：與傳統門診就診滿意度相比，網路門診就診滿意度較低，但多數患者表示使用網路門診後健康自我管理意識有所提升，顯示患者對於網路門診之就診體驗較佳。影響患者再次使用網路門診之因素主要與網路門診功能不完善及不能滿足患者需求有關。因此，醫院網路門診應再簡化就診流程，完善相應功能，如增加網上預約檢查以及復查等服務功能，以提高患者之就診滿意度。

Background: Because of the COVID-19 epidemic, people are mostly isolated at home and must seek medical advice over the internet. In addition, government authorities are currently investing greater efforts in developing internet hospitals. Purpose: The purpose of this essay was to assess how outpatients feel about online outpatient clinics and to analyze the factors that affect their satisfaction and willingness to return to these clinics. The results provide advice regarding how to more effectively encourage patients to use online outpatient clinics. Methods: A self-developed questionnaire was used to survey 191 patients who had visited the online outpatient clinic of a tertiary hospital in Sichuan Province from January to July 2019 . A descriptive analysis was conducted on the collected data, and factors influencing satisfaction were identified. Results: The majority of the surveyed patients were young or middle-aged (92.7%) and 42.9% held a college degree or higher. Nearly three-quarters (72.2%) expressed feeling satisfied or better with the online outpatient clinic, with 31.4% of these expressing feeling very satisfied. Nearly all (91.1%) expressed the opinion that the online outpatient clinic had improved their awareness of health self-management . Furthermore, 176 (92.1%) were willing to use the online outpatient clinic again. The results of univariate analysis showed that the main factors negatively influencing re-use of the online outpatient clinic were: failure to solve the problem in a timely manner (χ2 = 8.603, p = .045), the complicated process of online registration (χ2 = 8.322, p = .016), the failure of the online physical examination (χ2 = 8.958, p = .015), and unreliable quality (χ2 = 15.373, p = .004). Conclusion: The participants surveyed in this study reported a lower satisfaction for their online outpatient clinic experience than reported in similar surveys of traditional outpatient services. However, many reported that their health-related self-management awareness had improved after use, indicating that they feel better about the online outpatient clinic. The factors that affected willingness to reuse to the online outpatient clinic related mainly to imperfections related to the clinic and its inability to adequately meet patient needs. Online outpatient clinics should simplify the process of registration, improve functions, and increase service functions such as online examination appointments and follow-up visits to improve patient satisfaction.