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[1]陈云峰顾珊珊张春燕李甜甜姜政男潘雅萍.分级诊疗背景下社区卫生服务中心预约转诊患者失约影响因素分析[J].中国卫生质量管理,2025,32(11):84-88.[doi:10.13912/j.cnki.chqm.2025.32.11.17]
　CHEN Yunfeng,GU Shanshan,ZHANG Chunyan.Analysis of Influencing Factors on Non-Attendance among Patients with Referral Appointment at Community Health Service Centers under the Background of Hierarchical Medical System[J].Chinese Health Quality Management,2025,32(11):84-88.[doi:10.13912/j.cnki.chqm.2025.32.11.17]

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分级诊疗背景下社区卫生服务中心预约转诊患者失约影响因素分析

《中国卫生质量管理》[ISSN:1006-7515/CN:CN 61-1283/R] 卷: 32 期数: 2025年11期页码: 84-88 栏目: 基层卫生质量出版日期: 2025-11-15

Title:: Analysis of Influencing Factors on Non-Attendance among Patients with Referral Appointment at Community Health Service Centers under the Background of Hierarchical Medical System

作者:: 陈云峰顾珊珊张春燕李甜甜姜政男潘雅萍; 上海市宝山区高境镇社区卫生服务中心

Author(s):: CHEN Yunfeng; GU Shanshan; ZHANG Chunyan; Gaojing Town Community Health Service Center, Baoshan District

关键词:: 分级诊疗; 社区卫生服务中心; 预约转诊; 失约行为

Keywords:: Hierarchical Medical System; Community Health Service Center; Referral Appointment; Non-Attendance Behavior

分类号:: R197.3

DOI:: 10.13912/j.cnki.chqm.2025.32.11.17

文献标志码:: A

摘要:: 目的了解上海市宝山区社区卫生服务中心预约转诊患者失约现状，分析影响因素，为提升预约转诊服务效率提供参考。方法通过“上海市级分级诊疗平台”收集2024年4月1日—2025年4月30日宝山区各社区卫生服务中心预约转诊患者信息，对失约行为进行单因素和多因素回归分析。结果共纳入18 632例次预约转诊患者，总失约（撤销+爽约）率为31.6%（5 887例次），其中主动撤销占26.3%（1 551例次），爽约占73.7%（4 336例次）。单因素和多因素回归分析显示，预约到预约就诊间隔时间、转出社区地域分布、就诊卡类别、转诊原因为超出医疗机构诊疗范围、转诊医院属性、转诊医院地域分布、转诊科室类别、预约就诊日期季度分布等因素差异具有统计学意义（P＜0.05）。结论上海市宝山区社区卫生服务中心预约转诊患者失约率较高，需调整号源预约周期，建立号源动态调配与弹性预约机制，均衡优质医疗资源布局，强化基层诊疗能力，优化异地就医医保报销政策，并开展宣教。

Abstract:: ObjectiveTo understand the current status of appointment non-attendance among patients referred through the referral appointment system at community health service centers in Baoshan District, Shanghai, analyze the influencing factors, and provide references for improving the efficiency of referral appointment services. MethodsPatient information regarding referral appointments at community health service centers across Baoshan District was collected via the "Shanghai hierarchical medical system platform" from April 1, 2024, to April 30, 2025. Univariate and multivariate regression analyses were conducted on non-attendance behaviors. ResultsA total of 18 632 referral appointment cases were included, with an overall non-attendance rate (cancellations + no-shows) of 31.6% (5 887 cases). Among these, active cancellations accounted for 26.3% (1 551 cases), while passive no-shows accounted for 73.7% (4 336 cases). Univariate and multivariate analyses revealed statistically significant differences (P < 0.05) in factors such as the interval between appointment scheduling and the appointment visit, geographical distribution of the referring community, type of medical card, referral reason being beyond the diagnostic and treatment scope of the healthcare institution, attributes of the referral hospital, geographical distribution of the referral hospital, category of the referral department, and quarterly distribution of appointment visit dates.Conclusion The non-attendance rate among patients referred through the appointment system at community health service centers in Baoshan District, Shanghai, is relatively high. It is necessary to adjust the appointment cycle for medical slots, establish a dynamic allocation and flexible appointment mechanism for medical slots, balance the distribution of high-quality medical resources, strengthen primary-level diagnostic and treatment capabilities, optimize medical insurance reimbursement policies for cross-regional medical treatment, and conduct public education.

参考文献/References:

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更新日期/Last Update: 2025-11-15