关键词: 全科医学, 门诊医疗, 病人满意度, 咨询服务, 影响因素分析

Abstract: Background　In recent years，China has repeatedly issued relevant policies to encourage general hospitals to establish general practice department.In responding to the call，general practice department has been set up in most of general hospitals with a resident physician base，and its role in hierarchical diagnosis and treatment，bidirectonal referrals and reducing medical expense has achieved universal recognition.The Second Hospital of Hebei Medical University established department of general medicine in 2013，and set up a general practice outpatient consultation office."First consulting the general practitioner，then the specialist if the health problem needs further treatment"，the concept of triage of this hospital，is completely different from the traditional one.The action can reasonably and effectively allocate medical resources and provide convenience in accessing healthcare.Objective　To explore the role of outpatient consultation office of general practice department in general grade A tertiary hospitals by surveying patient satisfaction with it.Methods　In March 2018，from the Outpatient Consultation Office of General Practice Department，the Second Hospital of Hebei Medical University，we recruited 230 outpatients and surveyed them with a self-made questionnaire，General Practice Outpatient Consultation Experience.The questionnaire has three parts：basic personal information，status and thoughts about the outpatient consultation.In total，212 of them returned responsive questionnaires，achieving a response rate of 92.2%.Logistic regression analysis was used to assess factors influencing the satisfaction of treatment experience.Results　Of the 212 respondents，109（51.4%）were first-time visitors〔including 58（53.2%）who did not know the consulting department at all〕，138（65.1%）visited the department appropriately after consulting the nurse，61（28.8%）had an experience of registering the inappropriate department，and 159（75.0%）thought that it was necessary to set up the general practice outpatient consultation office.The overall patient satisfaction with the outpatient consultation was 84.9%（180/212）．To be specific，162（76.4%） were satisfied with the length of consulting the nurse，171（80.7%） were satisfied with the detailed explanation of the nurse，165（77.8%）were satisfied with the patience and professional levels of the nurse showed in the consultation，and 193（91.0%）were satisfied with the department for treatment recommended by the nurse.Multivariate Logistic regression analysis showed that the length of consulting the nurse，patience and professional levels of the nurse showed in the consultation，and the department for treatment recommended by the nurse were associated with patient satisfaction with general practice outpatient consultation（P<0.05）.Conclusion　The level of patient satisfaction with the care delivered by outpatient consultation office of general practice department is relatively high，which are affected mainly by nurse-patient communication and the appropriation level of department for treatment recommended by the nurse.

Key words: General practice, Ambulatory care, Patient satisfaction, Consultation service, Root cause analysis