背景:由于最近的进步,互联网医院已经成为中国典型的远程医疗平台。这些平台现在可以提供广泛的医疗服务,同时突破时间和空间的限制,具有出色的可访问性。
目的:本研究旨在从我国公立医院主办的互联网医院的特点方面对其角色延伸进行全面阐述,患者的利益和满意度,药剂师和药学服务的工作量。
方法:从复旦大学附属华山医院互联网医院信息系统自动获取网上处方总数和详细信息。年龄,性别,相关的处方部门,处方时间,付款方式,支出,药物类别和给药区域被纳入分析.随访问卷以电子形式分发,通过互联网收集和分析,以评估患者的满意度和时间/经济效益。
结果:从2020年5月至2022年3月,共有51,777名患者到互联网医院就诊并购买了所需药物。线上处方科室排名前5位的为皮肤科(83.11%),神经病学(6.85%),传染病(3.27%),胃肠病科(2.35%)和心内科(2.03%)。在此期间,审核药剂师平均每天审核240张处方,顾问药剂师每天回复约42次咨询。77.89%居住在中国西部地区的患者受益于互联网医院。他们节省了最长的时间(5天)和最多的费用(450-600美元)。我们观察到大多数维度的平均患者满意度得分高于4.5,包括药物可及性,有效的沟通和对医务人员的信心。在2022年4月至5月的封闭管理期间,共开出了194,388种药物,并向19,442名患者提供了总计1,547,001.2美元的付款。与关闭管理前相比,皮肤科就诊的患者比例从83.11%下降到54.87%。就诊于全科医学部的患者数量显着增加。药剂师每天延长5小时的工作时间。在2个月的关闭管理中,审核药剂师平均每天审核320张处方,顾问药剂师每天回复约138次咨询。
结论:互联网医院的科室和疾病特征与实体医院的优势学科一致。患者受益于互联网医院不仅在节约时间,还可以减少医疗费用。在关闭管理期间,科室分布和疾病概况发生了巨大变化。这些变化表明,互联网医院不再只是医院服务的延伸,但在抗击疫情方面发挥了重要作用,改变了特殊时期患者的医疗和医院诊疗模式。
BACKGROUND: As a result of recent advancements, Internet hospitals have been a typic kind of telemedicine platform in China. The platforms can now provide a wide range of medical services while breaking through the limitations of time and space with excellent accessibility.
OBJECTIVE: This study aims to give a comprehensive description on the role extension of a public hospital-sponsored Internet hospital in China from the aspects of the characteristics, patient\'s benefit and satisfaction, the workload of pharmacists and pharmaceutical care.
METHODS: The total number of online prescriptions and detailed information were obtained automatically from the Internet hospital information system from Huashan Hospital Fudan University. Age, sex, associated prescription departments, time of prescription, payment methods, expenditure, drug category and delivery region were included in the analysis. A follow-up questionnaire was distributed as an electronic form that was collected and analyzed through the Internet to evaluate patients\' satisfaction and time/economic benefits.
RESULTS: A total of 51,777 patients visited Internet hospital and purchased required drugs from May 2020 to March 2022. The top 5 online prescription departments were dermatology (83.11%), neurology (6.85%), infectious diseases (3.27%), gastroenterology (2.35%) and cardiology (2.03%) departments. During this period, the audit pharmacists reviewed an average of 240 prescriptions per day, and the consultant pharmacists replied to about 42 consultations per day. 77.89% patients living in westsourth China benefited most from the Internet hospitals. They saved longest time (5 days) and the most expenses ($450-600). We observed an average patient satisfaction score higher than 4.5 in majority dimensions, including drug accessibility, effective in communication and confidence in medical staff. During closed-off management period between April to May in 2022, a total of 194,388 drugs were prescribed and delivered to 19,442 patients with the total payments of $1,547,001.2. Compared with those before closed-off management, the proportion of patients visiting dermatology department reduced from 83.11% to 54.87%. There was a significant increase in the number of patients visited general practice medicine department. The pharmacists extended their working hours by 5 h per day. In 2 months close-off management, the audit pharmacists reviewed an average of 320 prescriptions per day, and the consultant pharmacists replied to about 138 consultations per day.
CONCLUSIONS: The characteristics of patients in terms of department and disease profiles in the Internet hospital were consistent with those preponderant disciplines in the entity hospital. Patients benefited from the Internet hospital not only in saving times, but also in reducing medical expenses. During the close-off management period, the distribution of departments and disease profiles changed dramatically. These changes indicated that the Internet hospital was no longer just an extension of in-hospital services, but played an important role in fighting the epidemic, changed the mode of patients\' medical treatment and hospital diagnosis and treatment at special times.