PDF(Pubmed)
Abstract：
BACKGROUND: Online appointment booking is a commonly used tool in several industries. There is limited evidence about the benefits and challenges of using online appointment booking in health care settings. Potential benefits include convenience and the ability to track appointments, although some groups of patients may find it harder to engage with online appointment booking. We sought to understand how patients in England used and experienced online appointment booking.
OBJECTIVE: This study aims to describe and compare the characteristics of patients in relation to their use of online appointment booking in general practice and investigate patients\' views regarding online appointment booking arrangements.
METHODS: This was a mixed methods study set in English general practice comprising a retrospective analysis of the General Practice Patient Survey (GPPS) and semistructured interviews with patients. Data used in the retrospective analysis comprised responses to the 2018 and 2019 GPPS analyzed using mixed-effects logistic regression. Semistructured interviews with purposively sampled patients from 11 general practices in England explored experiences of and views on online appointment booking. Framework analysis was used to allow for comparison with the findings of the retrospective analysis.
RESULTS: The retrospective analysis included 1,327,693 GPPS responders (2018-2019 combined). We conducted 43 interviews with patients with a variety of experiences and awareness of online appointment booking; of these 43 patients, 6 (14%) were from ethnic minority groups. In the retrospective analysis, more patients were aware that online appointment booking was available (581,224/1,288,341, 45.11%) than had experience using it (203,184/1,301,694, 15.61%). There were deprivation gradients for awareness and use and a substantial decline in both awareness and use in patients aged >75 years. For interview participants, age and life stage were factors influencing experiences and perceptions, working patients valued convenience, and older patients preferred to use the telephone. Patients with long-term conditions were more aware of (odds ratio [OR] 1.43, 95% CI 1.41-1.44) and more likely to use (OR 1.65, 95% CI 1.63-1.67) online appointment booking. Interview participants with long-term conditions described online appointment booking as useful for routine nonurgent appointments. Patients in deprived areas were clustered in practices with low awareness and use of online appointment booking among GPPS respondents (OR for use 0.65, 95% CI 0.64-0.67). Other key findings included the influence of the availability of appointments online and differences in the registration process for accessing online booking.
CONCLUSIONS: Whether and how patients engage with online appointment booking is influenced by the practice with which they are registered, whether they live with long-term conditions, and their deprivation status. These factors should be considered in designing and implementing online appointment booking and have implications for patient engagement with the wider range of online services offered in general practice.
OBJECTIVE: This study aims to describe and compare the characteristics of patients in relation to their use of online appointment booking in general practice and investigate patients\' views regarding online appointment booking arrangements.
METHODS: This was a mixed methods study set in English general practice comprising a retrospective analysis of the General Practice Patient Survey (GPPS) and semistructured interviews with patients. Data used in the retrospective analysis comprised responses to the 2018 and 2019 GPPS analyzed using mixed-effects logistic regression. Semistructured interviews with purposively sampled patients from 11 general practices in England explored experiences of and views on online appointment booking. Framework analysis was used to allow for comparison with the findings of the retrospective analysis.
RESULTS: The retrospective analysis included 1,327,693 GPPS responders (2018-2019 combined). We conducted 43 interviews with patients with a variety of experiences and awareness of online appointment booking; of these 43 patients, 6 (14%) were from ethnic minority groups. In the retrospective analysis, more patients were aware that online appointment booking was available (581,224/1,288,341, 45.11%) than had experience using it (203,184/1,301,694, 15.61%). There were deprivation gradients for awareness and use and a substantial decline in both awareness and use in patients aged >75 years. For interview participants, age and life stage were factors influencing experiences and perceptions, working patients valued convenience, and older patients preferred to use the telephone. Patients with long-term conditions were more aware of (odds ratio [OR] 1.43, 95% CI 1.41-1.44) and more likely to use (OR 1.65, 95% CI 1.63-1.67) online appointment booking. Interview participants with long-term conditions described online appointment booking as useful for routine nonurgent appointments. Patients in deprived areas were clustered in practices with low awareness and use of online appointment booking among GPPS respondents (OR for use 0.65, 95% CI 0.64-0.67). Other key findings included the influence of the availability of appointments online and differences in the registration process for accessing online booking.
CONCLUSIONS: Whether and how patients engage with online appointment booking is influenced by the practice with which they are registered, whether they live with long-term conditions, and their deprivation status. These factors should be considered in designing and implementing online appointment booking and have implications for patient engagement with the wider range of online services offered in general practice.
摘要：
背景：在线预约是多个行业中常用的工具。关于在医疗保健环境中使用在线预约的好处和挑战的证据有限。潜在的好处包括便利和跟踪约会的能力，尽管一些患者群体可能会发现更难参与在线预约。我们试图了解英格兰的患者如何使用和体验在线预约。
目的：本研究旨在描述和比较患者在一般实践中使用在线预约的特点，并调查患者对在线预约安排的看法。
方法：这是一项基于英语全科医学的混合方法研究，包括对全科医学患者调查（GPPS）的回顾性分析和对患者的半结构化访谈。回顾性分析中使用的数据包括对2018年和2019年GPPS的反应，使用混合效应逻辑回归分析。对来自英格兰11个一般诊所的有目的地抽样的患者进行半结构化访谈，探讨了在线预约的经验和观点。框架分析用于与回顾性分析的结果进行比较。
结果：回顾性分析包括1,327,693名GPPS应答者（2018-2019年合并）。我们对具有各种经验和在线预约意识的患者进行了43次访谈；在这43名患者中，6人（14％）来自少数民族。在回顾性分析中，更多的患者知道在线预约可用(581,224/1,288,341,45.11%),而有使用经验的患者(203,184/1,301,694,15.61%).在75岁以上的患者中，意识和使用存在剥夺梯度，意识和使用显着下降。对于面试参与者，年龄和生活阶段是影响经验和观念的因素，工作患者重视便利，老年患者更喜欢使用电话。患有长期疾病的患者更了解（比值比[OR]1.43，95％CI1.41-1.44），并且更有可能使用（OR1.65，95％CI1.63-1.67）在线预约。长期条件的访谈参与者将在线预约预订描述为对常规非紧急预约有用。贫困地区的患者聚集在GPPS受访者中，意识和使用在线预约预约的实践较低（OR为0.65，95％CI0.64-0.67）。其他关键发现包括在线预约的可用性的影响以及访问在线预订的注册过程中的差异。
结论：患者是否以及如何参与在线预约受注册实践的影响，他们是否长期生活，以及他们的剥夺状态。在设计和实施在线预约时，应考虑这些因素，并对患者参与一般实践中提供的更广泛的在线服务产生影响。
目的：本研究旨在描述和比较患者在一般实践中使用在线预约的特点，并调查患者对在线预约安排的看法。
方法：这是一项基于英语全科医学的混合方法研究，包括对全科医学患者调查（GPPS）的回顾性分析和对患者的半结构化访谈。回顾性分析中使用的数据包括对2018年和2019年GPPS的反应，使用混合效应逻辑回归分析。对来自英格兰11个一般诊所的有目的地抽样的患者进行半结构化访谈，探讨了在线预约的经验和观点。框架分析用于与回顾性分析的结果进行比较。
结果：回顾性分析包括1,327,693名GPPS应答者（2018-2019年合并）。我们对具有各种经验和在线预约意识的患者进行了43次访谈；在这43名患者中，6人（14％）来自少数民族。在回顾性分析中，更多的患者知道在线预约可用(581,224/1,288,341,45.11%),而有使用经验的患者(203,184/1,301,694,15.61%).在75岁以上的患者中，意识和使用存在剥夺梯度，意识和使用显着下降。对于面试参与者，年龄和生活阶段是影响经验和观念的因素，工作患者重视便利，老年患者更喜欢使用电话。患有长期疾病的患者更了解（比值比[OR]1.43，95％CI1.41-1.44），并且更有可能使用（OR1.65，95％CI1.63-1.67）在线预约。长期条件的访谈参与者将在线预约预订描述为对常规非紧急预约有用。贫困地区的患者聚集在GPPS受访者中，意识和使用在线预约预约的实践较低（OR为0.65，95％CI0.64-0.67）。其他关键发现包括在线预约的可用性的影响以及访问在线预订的注册过程中的差异。
结论：患者是否以及如何参与在线预约受注册实践的影响，他们是否长期生活，以及他们的剥夺状态。在设计和实施在线预约时，应考虑这些因素，并对患者参与一般实践中提供的更广泛的在线服务产生影响。
