Xie Wanhua, Cao Xiaojun
Outpatient Department, Guangzhou Women and Children's Medical Center, Guangzhou Medical University, Guangzhou, China.
Guangdong Provincial Clinical Research Center for Child Health, Guangzhou, China.
JMIR Form Res. 2023 Jan 26;7:e43167. doi: 10.2196/43167.
Waiting for a long time to make payments in outpatient wards and long queues of insured patients at the checkout window are common in many hospitals across China. To alleviate the problem of long queues for payment, many hospitals in China have established various mobile apps that those without health insurance can use. However, medically insured outpatients are still required to pay manually at the checkout window. Therefore, it is urgent to use information technology to innovate and optimize the outpatient service process, implement mobile payment for medically insured outpatients, and shorten the waiting time for outpatients, especially in the context of the COVID-19 epidemic. Furthermore, smartphone-based mobile payment for outpatients with health insurance could be superior to on-site cashier billing.
This study aimed to investigate the impact of smartphone-based mobile payment in relation to different aspects, such as waiting time, satisfaction with patients' waiting time, payment experience, the proportion of those dissatisfied with payment, total outpatient satisfaction, and outpatient volume, and compare mobile payment with on-site payment.
This was a historically controlled study. This study analyzed the outpatients' waiting time to make a medical insurance payment, their satisfaction with the waiting time and payment experience, the proportion of those dissatisfied with payment, and the outpatient volume of patients at Guangzhou Women and Children's Medical Center 1 year before and after the implementation of mobile payment for medical insurance in January 2021. An independent sample 2-tailed t test was used to compare waiting time, satisfaction with waiting time, and overall satisfaction. Paired sample 2-tailed t test was used to compare monthly outpatient visits. The chi-square test was used to compare the percentages of patients dissatisfied with payment.
After the implementation of mobile payment for medical insurance outpatients, the patients' payment waiting time was significantly shortened (mean 45.28, SD 10.35 min vs mean 1.02, SD 0.25 min; t=53.396; P<.001), and satisfaction with waiting time and payment experience were significantly improved (mean 82.08, SD 3.17 vs mean 90.36, SD 3.45; t=-118.65; P<.001). Dissatisfaction with payment significantly decreased (10.27%, SD 2.18% vs 1.19% vs SD 0.30%; P<.001). The total satisfaction of outpatients significantly improved (mean 86.91, SD 3.23 vs mean 89.98, SD 3.31; t=-44.57; P<.001), and the outpatient volume increased (248,105.58, SD 89,280.76 vs 303,194.75, SD 53,773.12; t=2.414; P=.03). Furthermore, payment efficiency improved, and the number of the on-site cashiers substantially decreased.
Mobile payment for health insurance significantly shortened patients' payment waiting time; improved patient satisfaction on waiting time and payment experience and overall satisfaction; reduced the proportion of patients who were dissatisfied with payment and the cashier at the hospital; and increased monthly outpatient volume. This approach was effective and thus worthy of promoting.
在中国许多医院，门诊病房付款等待时间长以及参保患者在结账窗口排起长队的情况很常见。为缓解付款排队问题，中国许多医院都开发了各种移动应用程序供无医保人员使用。然而，参保门诊患者仍需在结账窗口人工付款。因此，利用信息技术创新和优化门诊服务流程、实现参保门诊患者移动支付并缩短门诊患者等待时间迫在眉睫，尤其是在新冠疫情背景下。此外，基于智能手机的参保门诊患者移动支付可能优于现场收银计费。
本研究旨在调查基于智能手机的移动支付在等待时间、患者对等待时间的满意度、支付体验、对支付不满意的比例、门诊患者总体满意度以及门诊量等不同方面的影响，并将移动支付与现场支付进行比较。
这是一项历史对照研究。本研究分析了广州妇女儿童医疗中心在2021年1月实施医保移动支付前后1年门诊患者医保支付等待时间、对等待时间和支付体验的满意度、对支付不满意的比例以及门诊量。采用独立样本双侧t检验比较等待时间、对等待时间的满意度和总体满意度。采用配对样本双侧t检验比较月门诊量。采用卡方检验比较对支付不满意患者的百分比。
实施医保门诊患者移动支付后，患者支付等待时间显著缩短（均值45.28，标准差10.35分钟 vs 均值1.02，标准差0.25分钟；t = 53.396；P <.001），对等待时间和支付体验的满意度显著提高（均值82.08，标准差3.17 vs 均值90.36，标准差3.45；t = -118.65；P <.001）。对支付的不满意显著降低（10.27%，标准差2.18% vs 1.19%，标准差0.30%；P <.001）。门诊患者总体满意度显著提高（均值86.91，标准差3.23 vs 均值89.98，标准差3.31；t = -44.57；P <.001），门诊量增加（248,105.58，标准差89,280.76 vs 303,194.75，标准差53,773.12；t = 2.414；P =.03）。此外，支付效率提高，现场收银员数量大幅减少。
医保移动支付显著缩短了患者支付等待时间；提高了患者对等待时间和支付体验的满意度以及总体满意度；降低了对支付不满意的患者比例以及医院收银员相关不满比例；并增加了月门诊量。这种方法有效，值得推广。
