目的 探讨门诊实施“先诊疗后结算”,促进就医流程再造.方法 随机抽取2016年5月-10月门诊就诊患者,采用前瞻性、半随机对照试验、单盲的方法,将患者按照结算方式分为实验组(先诊疗后结算组)和对照组(先结算后诊疗组),监测记录两组交易环节耗时及总耗时与患者满意度.结果 交易环节耗时及总耗时实验组低于对照组(P＜0.01);患者满意度实验组高于对照组(P＜0.01).结论 “先诊疗后结算”模式较传统结算模式交易耗时短、环节少,患者满意度高,解决了“三长一短”等问题,体现了“以患者为中心”的服务理念,提高了门诊服务质量与就诊效率.%Objective To explore the effectiveness of the implementation of "settlement after medical care" to help the medical process reengineering.Methods A prospective,semi-randomized controlled trial and a single-blind method were used to recruit patients from May to October 2016.The patients were divided into the experimental group (settlement after medical care) and the control group (pre-paid group),and the trading time-consuming and total time-consuming and patient satisfaction level were recorded and analyzed.Results The trading time-consuming and total time-consuming in the experimental group was lower than that of the control group (P＜0.01).The satisfaction rate of the patients in the experimental group was higher than that in the control group (P＜0.01).Conclusion The "post-paid medical care" mode was less time-consuming than the traditional mode,with fewer links and higher satisfaction rate,which solved the problem of "three-length and one short" and reflected the "patient-centered" service concept with improvement on outpatient service quality and medical care efficiency.
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