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国家卫生健康委员会
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单位:100191北京大学第三医院医务处(宋涵超),门诊部(林晨曦、雷祎、刘梅、黄潆姗、朴玉粉)
英文关键词:
目的 探讨北京大学第三医院医药分开综合改革实施前后门诊投诉的变化,分析发生原因,尝试提出对策与建议。方法 对北京大学第三医院2016年4—11月与2017年4—11月门诊投诉数据按照诊疗流程进行分类,对北京市医药分开综合改革实施前后的投诉数据进行对比分析。对门诊投诉接待人员进行访谈,了解改革实施前后门诊投诉发生的变化。结果 北京市医药分开综合改革实施后投诉例数同比增长率呈上升趋势,2016年4月与2017年4月门诊投诉例数分别为67、73例,5月分别为53、62例,6月分别为45、62例,7月分别为39、63例,2017年同比增长率分别为8.96%(6/67)、16.98%(9/53)、37.78%(17/45)、61.54%(24/39)。对2016年4—11月与2017年4—11月投诉数据进行对比发现,投诉构成比变化最大的是退号环节,2016年4—11月为1.42%(6/423),2017年4—11月增加到14.50%(68/469)。关于微信挂号、开处方、医患沟通、费用报销、退费流程的投诉增加,关于服务态度、科室管理的投诉减少。结论 医事服务费是造成门诊投诉内容发生变化的主要原因,推进分级诊疗制度有助于改善医疗服务。
Objective To investigate the changes of outpatient complaints before and after comprehensive reform of separation of drug sales from medical services in Peking University Third Hospital; to analyze the causes and discuss the countermeasures. Methods Records of outpatient complaints between April and November in 2016-2017 were classified according to the treatment process and analyzed before and after Beijing′s comprehensive reform of abolishing drug-markup. Interviews were conducted among desk clerks. Results There were 67 complaints in April 2016 and 73 complaints in April 2017, the growth rate was 8.96%(6/67); there were 53 complaints in May 2016 and 62 complaints in May 2017, the growth rate was 16.98%(9/53); there were 45 complaints in June 2016 and 62 complaints in June 2017, the growth rate was 37.78%(17/45); there were 39 complaints in July 2016 and 63 complaints in July 2017, the growth rate was 61.54%(24/39); there was a upward tendency of the growth rate. Composition ratio of complaints about deregistration was the most significant change between 2016 and 2017; the deregistration rate was 1.42%(6/423) from April to November in 2016 and 14.50%(68/469) from April to November in 2017. Complaints about WeChat registration, prescription, doctor-patient communication, expense reimbursement and refund process were increased; complaints about service attitude and department management were decreased. Conclusion Medical service fee is the main cause of outpatient complaints; promoting hierarchical medical system is important in the improvement of medical services.
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