Impact of adjustment measures on reducing outpatient waiting time in a community hospital: application of a computer simulation
Impact of adjustment measures on reducing outpatient waiting time in a community hospital: application of a computer simulation
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DOI：
10.3760/cma.j.issn.0366-6999.2010.05.013
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发表时间：
2010-03-05
影响因子：
6.1
通讯作者：
Miao Wei-jun
中科院分区：
文献类型：
--
作者：
Chen Bai-lian;Li En-dong;Miao Wei-jun
背景技术等待时间作为患者满意度的重要决定因素，在医疗保健服务领域越来越受到关注。本研究旨在通过计算机模拟的方法阐明社区医院候诊时间的分布特征，并探讨减少门诊候诊时间的潜在措施的影响。方法在2006年为期一个月的研究期间，对中国上海的一家社区医院进行了一项横断面研究。根据挂号时间和缴费时间的记录，计算出门诊等候时间的基线数据。采用模拟技术探讨透视改革方法对减少候诊时间的影响。结果本研究共收集10 092名患者和26 816次就诊数据，共纳入19 947次就诊。该院门诊患者平均就诊总时间上午43.6分钟，下午19.1分钟，全天研究时段平均34.3分钟。仿真结果表明，通过引入预约制，根据工作日不同时间候诊的患者数量，灵活的以需求为导向的排班，可以大大减少门诊病人的候诊时间。结论采用预约制，灵活管理排班可能是实现减少候诊时间的有效途径。中华医学杂志 2010,123(5):574-580
Background As an important determinant of patient satisfaction, waiting time, has gained increasing attention in the field of health care services. The present study aimed to illustrate the distribution characteristics of waiting time in a community hospital and explore the impact of potential measures to reduce outpatient waiting time based on a computer simulation approach.Methods During a one-month study period in 2006, a cross-sectional study was conducted in a community hospital located in Shanghai, China. Baseline data of outpatient waiting time were calculated according to the records of registration time and payment time. A simulation technique was adopted to investigate the impact of perspective reform methods on reducing waiting time.Results Data from a total of 10 092 patients and 26 816 medical consultations were collected in the study and 19 947 medical consultations were included. The average of the total visit time for outpatients in this hospital was 43.6 minutes in the morning, 19.1 minutes in the afternoon, and 34.3 minutes for the whole day studied period. The simulation results suggested that waiting time for outpatients could be greatly reduced through the introduction of appointment system and flexible demand-orientated doctor scheduling according to the numbers of patients waiting at different time of the workday.Conclusion Adoption of an appointment system and flexible management of doctor scheduling maybe effective way to achieve decreased waiting time. Chin Med J 2010,123(5):574-580