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计算机化电话护士分诊。服务质量与成本评估。

Computerized telephone nurse triage. An evaluation of service quality and cost.

作者信息

Cariello Francesca P

机构信息

Department of Performance Improvement, Naval Medical Clinic, Quantico, Va., USA.

出版信息

J Ambul Care Manage. 2003 Apr-Jun;26(2):124-37. doi: 10.1097/00004479-200304000-00005.

Abstract

The current reimbursement structure of health care in the United States motivates the providers of health care services to deliver these services with a cost-conscious mentality without compromising quality. This has led to the development of alternative methods of delivering health care services, one of which is computerized telephone nurse triage. This study investigates service quality from the perception of callers who used this system on behalf of a pediatric client. Cost was evaluated by comparing what the caller would have done if they did not speak with nurse triage with what they actually did after their interaction. A modified version of the SERVQUAL tool was administered via telephone survey to members of a managed health care plan who recently used nurse triage services for a pediatric patient. Findings were that the majority of callers--employed female parents--rated the level of service quality very highly. Education, employment status, age of the caller, child gender, birth order among siblings, and age of child did not affect the rating of service quality. Relationship to the child had an effect on the rating of service quality as men/fathers rated the level of service quality slightly lower than their female/mother counterparts. The evaluation of cost revealed that the action taken by the caller after they spoke with the nurse resulted in significant cost savings. Computerized telephone nurse triage is a well-accepted cost-saving alternative method of health care delivery that can effectively serve a variety of callers and pediatric patients.

摘要

美国当前的医疗保健报销结构促使医疗服务提供者在不降低质量的前提下,以注重成本的心态提供这些服务。这导致了提供医疗保健服务的替代方法的发展,其中之一是计算机化电话护士分诊。本研究从代表儿科客户使用该系统的来电者的感知角度调查服务质量。通过比较来电者在未与护士分诊交谈时会采取的行动与互动后实际采取的行动来评估成本。通过电话调查向最近为儿科患者使用护士分诊服务的管理式医疗保健计划成员发放了修改版的SERVQUAL工具。结果发现,大多数来电者——受雇的女性家长——对服务质量水平评价很高。来电者的教育程度、就业状况、年龄、孩子性别、兄弟姐妹中的出生顺序以及孩子的年龄均不影响服务质量评分。与孩子的关系对服务质量评分有影响,因为男性/父亲对服务质量水平的评分略低于女性/母亲。成本评估显示,来电者与护士交谈后采取的行动节省了大量成本。计算机化电话护士分诊是一种广受欢迎的节省成本的替代医疗保健提供方法,可有效服务于各类来电者和儿科患者。

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