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中国防痨杂志 ›› 2021, Vol. 43 ›› Issue (4): 398-403.doi: 10.3969/j.issn.1000-6621.2021.04.017

• 论著 • 上一篇    下一篇

互联网诊疗平台对结核病患者的复诊体验调查

周爽, 陈楠, 朱坤, 姜慧, 杨磊, 杜建()   

  1. 101149 首都医科大学附属北京胸科医院 北京市结核病胸部肿瘤研究所院务办公室(周爽、杜建),团委办公室(陈楠),科技处(姜慧),医务处(杨磊);北京结核病诊疗技术创新联盟远程医疗部(朱坤)
  • 收稿日期:2020-11-27 出版日期:2021-04-10 发布日期:2021-04-09
  • 通信作者: 杜建 E-mail:jdusdu@163.com
  • 基金资助:
    北京市医院管理中心2020年度(第六期)“青苗”计划(QML20201602);首都医科大学医院管理研究所2020年度开放性课题(2020YGS06)

Investigation of the experience of tuberculosis patients for follow up using the internet platform

ZHOU Shuang, CHEN Nan, ZHU Kun, JIANG Hui, YANG Lei, DU Jian()   

  1. Hospital Office, Beijing Chest Hospital, Capital Medical University, Beijing Tuberculosis and Thoracic Tumor Research Institute, Beijing 101149, China
  • Received:2020-11-27 Online:2021-04-10 Published:2021-04-09
  • Contact: DU Jian E-mail:jdusdu@163.com

摘要:

目的 分析新型冠状病毒肺炎疫情期间结核病患者借助互联网诊疗平台进行复诊的就诊体验。方法 对2020年2—6月曾参与首都医科大学附属北京胸科医院线上问诊咨询,且完成互联网诊疗及药品寄送全流程的131例符合复诊标准的结核病患者进行问卷调查,问卷有效回收率为96.9%(127/131)。采用李克特(Likert)5级评分法评价调查对象满意度,并对其诊前、诊中、诊后3个维度的就诊体验进行分析。结果 调查对象满意度为93.7%(119/127),其中,>45岁、环京地区和其他地区、患病时长≥6个月者的满意度[分别为97.3%(36/37)、95.9%(94/98)、95.1%(98/103)]明显高于<30岁、北京地区、患病时长<6个月者[分别为90.0%(45/50)、86.2%(25/29)、87.5%(21/24)],差异均有统计学意义(χ2=3.650, P=0.004;χ2=3.243,P=0.008;χ2=3.233,P=0.008)。“主诊医生推荐”是其他地区患者主要信息获取途径[54.7%(35/64)],而北京地区“前往医院“获知的比率[44.8%(13/29)]明显高于其他地区[1.6%(1/64)],差异有统计学意义(χ2=36.015, P<0.01);“疫情原因不能外出”[81.1%(103/127)]是选择互联网诊疗的主要原因,且其他地区调查对象的选择比率[87.5%(56/64)]明显高于北京地区 [65.5%(19/29)],差异有统计学意义(χ2=6.340, P=0.042);而北京地区调查对象选择“门诊挂不上号”的比率[51.7%(15/29)]明显高于其他地区调查对象[18.8%(12/64)],差异有统计学意义(χ2=10.764, P=0.005);48.8%(62/127)的调查对象在就诊前“没有顾虑”,但环京地区对于“担心网上问诊医生对患者病情把控不准确”的顾虑[50.0%(17/34)]明显高于其他地区[25.0%(16/64)],差异有统计学意义(χ2=6.647,P=0.036)。78.0%(99/127)的调查对象认为互联网诊疗“降低了外出带来的感染风险”,未来希望通过互联网诊疗主要解决“复诊咨询”[55.9%(71/127)]及“远程开药和寄药”[57.5%(73/127)],且45岁以上者对于“降低了外出带来的风险”的期望值[62.2%(23/37)]明显低于30岁以下者[84.0%(42/50)],对于“复诊咨询”的期望值[73.0%(27/37)]明显高于30岁以下者[50.0%(25/50)],差异均有统计学意义(χ2=7.588, P=0.023;χ2=6.226, P=0.044);但仅有26.0%(33/127)的调查对象在疫情后“会优先选择网上诊疗”。结论 调查对象对疫情期间互联网诊疗的满意度高,但其选择意愿受疫情影响较大,互联网诊疗常态化运行需要寻找新的落脚点。

关键词: 结核, 问卷调查, 病例管理, 计算机通信网络, 接受意愿

Abstract:

Objective To analyze the tuberculosis (TB) patients’ experience of the follow-up medical treatment online during the COVID-19 epidemic. Methods A questionnaire survey was conducted among 131 TB patients partcipated in the online consultation of Beijing Chest Hosipital, Capital Medical University and completed the whole process of internet diagnosis and treatment and drug delivery. The effective recovery rate was 96.9% (127/131). Likert 5-level scoring system was used to evaluate patients’ satisfaction before, during and after visit. Results The results showed that the satisfaction of patients was 93.7% (119/127). The satisfaction of patients who older than 45 years, around Beijing and other areas, and disease course over 6 months were significantly higher than those of younger than 30 years, Beijing local, and disease course less than 6 months (97.3% (36/37) vs. 90.0% (45/50), χ2=3.650, P=0.004; 95.9% (94/98) vs. 86.2% (25/29),χ2=3.243, P=0.008; 95.1% (98/103) vs. 87.5% (21/24), χ2=3.233, P=0.008; respectively). For patients around Beijing and other areas, “ Recommendation of attending doctors”was the main way to obtain information (54.7% (35/64)). However, obtaining information mainly “after going to the hospital”was the main way for Beijing patients (44.8% (13/29)), the rate was significantly higher than that in the patients from other areas (1.6% (1/64),χ2=36.015, P<0.01). “Unable to go out because of epidemic” (81.1% (103/127)) was the main reason for choosing internet diagnosis and treatment. The rate of “out-patient number not available” in Beijing was significantly higher than that in other areas (51.7% (15/29) vs. 18.8% (12/64),χ2=10.764, P=0.005); 48.8% (62/127) of patients “had no concerns” before receive treatment on the internet, however, the rate of “the inaccurate diagnosis online” in patients around Beijing was significantly higher than that in patients from other areas (50.0% (17/34) vs. 25.0% (16/64), χ2=6.647, P=0.036); 78.0% (99/127) of the patients considered that internet diagnosis and treatment reduced the infection risk caused by going out, they hope to solve the problems of “follow-up consultation” (55.9% (71/127)) and “prescription and drug delivery” (57.5% (73/127)) mainly through internet in the future. In the patients older than 45, the willingness of “reduce the risk of going out” was significantly lower than those younger than 30 years (62.2% (23/37) vs. 84.0% (42/50), χ2=7.588, P=0.023), while the willingness of “follow up consultation” was significantly higher than those younger than 30 years (73.0% (27/37) vs. 50.0% (25/50), χ2=6.226, P=0.044). However, only 26.0% (33/127) of the patients would “prefer online diagnosis and treatment”. Conclusion Patients’ satisfaction of internet diagnosis and treatment was high in this survey, but the willingness was greatly affected by the epidemic. The normalization of internet diagnosis and treatment needs to find new ways.

Key words: Tuberculosis, Questionnaire survey, Case management, Computer communication networks, Acceptability