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越南医疗机构的门诊候诊时间:对医疗检查程序的政策影响

Outpatient Waiting Time at Vietnam Health Facilities: Policy Implications for Medical Examination Procedure.

作者信息

Nguyen Dinh-Hoa, Tran Dinh-Van, Vo Hoang-Long, Nguyen Si Anh Hao, Doan Thi-Ngoc-Ha, Nguyen Thi-Huyen-Trang

机构信息

Institute of Orthopedic Trauma, Viet Duc University Hospital, Hanoi 100000, Vietnam.

Social Affair Department, Viet Duc University Hospital, Hanoi 100000, Vietnam.

出版信息

Healthcare (Basel). 2020 Mar 20;8(1):63. doi: 10.3390/healthcare8010063.

Abstract

Our study aims to measure outpatient waiting times at Vietnam health facilities according to the socioeconomic characteristics. We employed the 2015 Vietnam District and Commune Health Facility Survey which was a cross-sectional study designed by the World Bank in collaboration with the Vietnam Health Strategy and Policy Institute. This survey was designed to be representative of six provinces (Dien Bien, Hanoi, Binh Dinh, Dak Lak, Dong Nai, and Dong Thap) drawn from six distinct geographical regions of Vietnam. Data from 4949 outpatients at district hospitals (DHs) and 1724 outpatients at commune health centers (CHCs) were extracted for final analysis. We recorded average outpatient waiting times of 32.58 min at DHs and of 11.58 min at CHCs. Four hundred and forty-five outpatients at DHs (9.0%) and 720 those at CHCs (42.8%) were examined immediately (waiting time = 0 min). Outpatient waiting times were various in six distinct geographical regions. With an investigation according to several socioeconomic characteristics, significant differences in outpatient waiting times were observed at both two levels of health facilities as measured by province, age, self-reported health status, patient's wealth, ethnicity, and health insurance. Outpatient waiting times from arrival at health facility until receiving care were significantly distinct amongst two health facility levels, revealing longer at DHs compared to at CHCs. There was significantly higher proportion of outpatients examined immediately at CHCs compared to at DHs. Our study suggests that, vulnerable populations, with longer outpatient waiting time, should be dealt with in appropriate models towards each medical facility according to key socioeconomic factors to contribute to simplify the process of medical examination and treatment for outpatients.

摘要

我们的研究旨在根据社会经济特征来衡量越南医疗机构的门诊等待时间。我们采用了2015年越南地区和社区卫生设施调查,这是世界银行与越南卫生战略和政策研究所合作设计的一项横断面研究。该调查旨在代表从越南六个不同地理区域抽取的六个省份(奠边、河内、平定、多乐、同奈和东威)。从地区医院(DHs)的4949名门诊患者和社区卫生中心(CHCs)的1724名门诊患者中提取数据进行最终分析。我们记录到地区医院的门诊平均等待时间为32.58分钟,社区卫生中心为11.58分钟。地区医院的445名门诊患者(9.0%)和社区卫生中心的720名门诊患者(42.8%)立即接受了检查(等待时间 = 0分钟)。门诊等待时间在六个不同地理区域各不相同。根据若干社会经济特征进行调查时,在省级、年龄、自我报告的健康状况、患者财富、种族和医疗保险等方面衡量,两个级别的医疗机构在门诊等待时间上均存在显著差异。从到达医疗机构到接受治疗的门诊等待时间在两个医疗机构级别之间存在显著差异,地区医院的等待时间比社区卫生中心更长。与地区医院相比,社区卫生中心立即接受检查的门诊患者比例显著更高。我们的研究表明,对于等待时间较长的弱势群体,应根据关键社会经济因素,针对每个医疗机构采用适当模式来处理,以有助于简化门诊患者的诊疗过程。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9f0e/7151016/40b9e362b49f/healthcare-08-00063-g001.jpg

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