三甲专科医院门诊预约挂号现状分析及对策

目的 通过对医院信息系统（HIS）门诊预约挂号的数据分析,探讨预约诊疗制度的经验与不足,以提高门诊挂号的预约面及降低预约挂号的失约率,从而优化门诊服务管理和资源配备.方法 从是否为专家预约,是否在预约时即刻收费,预约的具体方式等角度对预约挂号进行分类统计及横向对比,找出现有制度的效用与不足.结果 随着预约挂号制度的推进,预约挂号类型各自占比在动态变化.2011年宁波市康宁医院电话预约数3 188个（58.31％）,占总预约数比例最高,网上预约数1 752个（32.05％）,诊间预约数527个（9.64％）;随着市卫生网网上挂号系统进一步推广和患者对预约挂号制度知晓度的提高,2012年的情况也相应变化,预约数提升至7 229个（51.28％）,网上预约数5 154个（36.56％）,电话预约总数降为1 714个（12.16％）;但是主要问题仍为预约率低（2011为4.31％;2012年为10.14％）及失约率高（2011年为35.50％,2012年为26.37％）.2011年推出预约挂号制度,当年预约人数5 467个,2012年预约数达14097个.但与总体挂号数对比,患者更习惯于传统就诊模式,2011年预约挂号数占挂号总数126 755个的4.31％;2012年预约挂号数和预约数都有所增长,预约挂号占全年挂号总数138 958个的10.14％.不同职称间患者预约取号率差异无统计学意义（P＞0.05）.即时付费与否的失约率比较差异有统计学意义（P＜0.01）;心理咨询门诊的失约率较精神科门诊的失约率明显偏低,两组比较差异有统计学意义（P＜0.01）.结论 进一步加强门诊服务管理和宣传,完善信息平台,采用预约即时扣费及优化诊间预约来针对性改进.

Current situation and countermeasure of outpatient appointment registration in grade 3 and first class specialized subject hospital

Objective To explore the useful experience and shortcoming of the appointment system through the data analysis of HIS outpatient appointment registration,in order to improve the outpatient registration appointment face and reduce the rate of non-attendance,further to optimize the management and resource of outpatient service.Methods The appointment registration was classified and transversely compared to find out the effectiveness and shortcomings of existing system according to whether or not make an appointment from experts,whether or not pay the money for appointment immediately,the specific way of appointment.Results With the advancement of appointment registration system,the proportion of the type of appointment registration was dynamic changes.In Ningbo Kangning hospital,a the number of people made telephone appointment was3 188 （58.31%）,and was the highest proportion of the number of reservation; the number of people made network appointment was 1 752 （32.05%） ; the number of people made the appointment at clinical intervals was 527 （9.64%）.The awareness rate of appointment registration was increased accompany with the promotion of online registration system in the city health network.The main problems were the low rate of appointment （4.31% in 2011,10.14% in 2012） and the high rate of non-attendance （35.50% in 2011,26.37% in 2012）.The appointment registration system in our hospital was launched in 2011,and the number of people made the appointment was 5 467 （5467/126 755,4.31%）,and the patients were more accustomed to the traditional medical mode.The number of people made the appointment and the total number of people made the registration were increased in 2012,and the number of people made the appointment was 14 097 （14 097/138 958,10.14%）.No differences was found in the arrival rate of appointment registration in the patients with difference title （P 〉 0.05）.The rate of non-attendance in the department of psychological consultation was significantly lower than that in the department of psychiatric,and the difference was statistically significant （P 〈0.01）.Conclusions The improvements are carried out through strengthening the outpatient service management and propaganda,improving information platform,paying the money for appointment at once and optimizing the appointment at clinical intervals.