Douglas K M J, Potter T, Treharne G J, Obrenovic K, Hale E D, Pace A, Mitton D, Erb N, Whallett A, Delamere J P, Kitas G D
Department of Rheumatology, The Guest Hospital, Tipton Road, Dudley, West Midlands DY1 4SE, UK.
Rheumatology (Oxford). 2005 Jan;44(1):80-2. doi: 10.1093/rheumatology/keh403. Epub 2004 Sep 14.
To determine the preferences of rheumatology patients for the time and location of their out-patient appointments.
All patients attending the rheumatology out-patient services at Dudley Group of Hospitals NHS Trust over a 2-week period were asked to complete a purpose-designed, scannable, previously piloted, self-administered questionnaire.
Four hundred and nineteen patients completed questionnaires (response rate 87%). Age ranged from 16 to 92 yr; 38% of responders were over 65 yr, 72% were female, 57% had an inflammatory arthritis, 20% had a connective tissue disease, 8% had degenerative joint disease and 15% had another diagnosis; 29% were employed, 51% retired and 20% unemployed. Fewer than 1% of patients would like to be seen at community general practice centres (99.3% would prefer a hospital site). Proximity to their home was the main determinant of hospital choice. Monday was the most popular day for appointments, and days from Tuesday to Friday received equal rankings. Only 0.5% of patients would choose a weekend clinic. Fifty-eight per cent of patients would prefer morning appointments, 24% afternoon appointments and 2% evening appointments; 16% did not mind. Only being employed predicted out-of-hours preference.
In this predominantly suburban, industrialized area, rheumatology out-patients prefer to be seen in the hospital rather than primary care environment, ideally close to their home, with appointments in the morning and on a weekday. These results may be generalizable to other districts and other chronic disease states, but we suggest that similar surveys become part of routine service provision and inform current and future planning.
确定风湿病患者对门诊预约时间和地点的偏好。
要求在达德利集团国民保健服务信托基金医院风湿病门诊服务部门就诊的所有患者,在两周内完成一份专门设计的、可扫描的、先前已进行过预试验的自填式问卷。
419名患者完成了问卷(回复率87%)。年龄范围为16至92岁;38%的回复者年龄超过65岁,72%为女性,57%患有炎性关节炎,20%患有结缔组织病,8%患有退行性关节病,15%有其他诊断;29%受雇,51%退休,20%失业。不到1%的患者希望在社区全科医疗中心就诊(99.3%更喜欢医院地点)。距离家近是选择医院的主要决定因素。周一是最受欢迎的预约日,周二至周五的受欢迎程度相同。只有0.5%的患者会选择周末门诊。58%的患者更喜欢上午就诊,24%更喜欢下午就诊,2%更喜欢晚上就诊;16%无所谓。只有受雇情况能预测非工作时间的偏好。
在这个以郊区为主的工业化地区,风湿病门诊患者更喜欢在医院而非基层医疗环境就诊,理想情况是离家近,且在工作日上午就诊。这些结果可能适用于其他地区和其他慢性病,但我们建议类似调查应成为常规服务的一部分,并为当前和未来的规划提供参考。