复旦儿科医联体门诊就诊患儿家长满意度及影响因素分析

目的 了解门诊患儿家长对复旦儿科医联体成员单位的满意度及其影响因素，为提升服务水平和提高服务质量提出改进建议和参考。方法 采用问卷调查法从就诊环境条件和设施、诊疗资源配置和流程、总体医疗费用、总体就诊时间、医师的诊疗行为、药师的药学服务、护师的护理服务、其他医疗技术人员的服务和药品供应的满意度等9个方面，对在复旦儿科医联体内62家成员单位就诊的1 660名儿童家长开展满意度调查。结果 受访者对复旦儿科医联体内各级医院总体满意度和医师诊疗满意度无显著差异；在药品供应满意度指标上，受访者对复旦儿科医联体三级医院的满意度高于二级医院和社区医院，差异有统计学意义（P<0.01）；在总体就诊时间和总体医疗费用的满意度指标上，受访者对复旦儿科医联体三级医院的满意度低于社区医院，差异有统计学意义（P<0.01）。相较于年收入<5万的受访者，年收入5~10万和11~20万者对各级医院药品供应、总体就诊时间的满意度更高（OR=2.07，P<0.05；OR=2.27，P<0.01；OR=2.55，P<0.01；OR=1.93，P<0.01），但收入到20万以上之后，满意度较中间收入水平反而有所下降。与首诊选择三级医院的家长相比，21%首诊选择二级和社区医院的家长对医联体政策较了解（P<0.01）。结论 复旦儿科医联体工作初见成效，建议进一步增加成员单位药品种类，提高儿童家长满意度，进一步提升优质儿科医疗资源的可及性。

Satisfaction and associated factors of children's parents in the outpatient of Fudan Pediatric Medical Alliance

Objective To investigate the satisfaction and its influencing factors of children's parents to members of Fudan Pediatric Medical Alliance, and to evaluate the effect of graded diagnosis and treatment, so as to provide reference for improving the service. Methods Questionnaire survey was used to investigate the satisfaction of children's parents from 62 members of Fudan Pediatric Medical Alliance in 9 aspects:environment and facilities, allocation and flow of medical resources,overall medical costs,medical treatment time,doctor's behavior,pharmaceutical care,nursing service,other medical technicians' service and drug supply. Results There was no significant difference in the overall satisfaction of all levels of hospitals and doctors' diagnosis and treatment satisfaction.On the satisfaction indicator of drug supply,the respondents were more satisfied with tertiary hospitals of Fudan Pediatric Medical Alliance than the secondary and community hospitals (P<0.01).In terms of the two satisfaction indicators of medical treatment time and overall medical costs, the satisfaction of respondents were less satisfied with the tertiary hospitals of Fudan Pediatric Medical Alliance than the secondary and community hospitals (P<0.01).Compared with those with an annual income of less than 50 000,the respondents with an annual income of 50 000-100 000 and 110 000-200 000 were more satisfied with the level of medical treatment time and drug supply (OR=2.07,P<0.05;OR=2.27,P<0.01;OR=2.55,P<0.01;OR=1.93,P<0.01).However,when the income was more than 200 000,the satisfaction level was lower than the middle income level.Compared with the parents who chose the tertiary hospital for the first visit, 21% of the parents who chose the secondary hospitals and community hospitals for the first visit had a better understanding of this policy (P<0.01). Conclusion The establishment of Fudan Pediatric Medical Alliance has promoted the development of high-quality medical resources to community hospitals.It is suggested to further increase the drug category of member units,so as to elevate the satisfaction of patients' family and provide better pediatric medical services for patients.