A comparative study of online and offline outpatient services in a large hospital—taking neurology department as an example_Chinese Journal of Evidence-Based Medicine

Authors：

GUAN Qiaozhi ¹ , XIAO Shiwei ² ,  WEN Jin ³

1. Department of Operation and Management, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;
2. West China School of Basic Medical Sciences and Forensic Medicine, Sichuan University, Chengdu 610041, P. R. China;
3. Institute of Hospital Management, West China Hospital, Sichuan University, Chengdu 610041, P. R. China;

Corresponding author：

WEN Jin, Email: huaxiwenjin@163.com

Keywords：

Online outpatient clinic; Word frequency analysis; Effect

DOI：

10.7507/1672-2531.202501122

Video：

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Objective Taking neurology as an example, to analyze the impact of the development of online outpatient services of a hospital on the volume of offline outpatient business and the composition of patients, and to provide a reference for the coordinated management of online and offline services. Methods Descriptive statistics, analysis of variance (ANOVA), rank sum test, correlation statistics, lexical processing and word frequency statistics were used to analyze the online and offline outpatient visits, outpatient diagnoses and other related information of the Department of Neurology of a certain hospital from 2020 to 2023. And to compare the differences in the business volume, the percentage of patients with initial diagnosis, the outpatient inpatient conversion rate, and the composition of outpatient diseases in the observation period. Results Between 2020 and 2023, online outpatient visits increased by 350%, while offline visits decreased by 8%, leading to an overall increase of 11% in total outpatient visits. The proportion of online and offline first visits increased by 8% and 11%, respectively, and the online and offline outpatient-hospitalization conversion rates increased by 22% and 46%, respectively. In addition, online and offline outpatient visits showed a significant negative correlation, with a correlation coefficient of −0.29. Online outpatient visits showed a significant positive correlation with offline outpatient-hospitalization conversion rates, with a correlation coefficient of 0.69. There was a significant positive association between the percentage of online first visits and the online and offline inpatient admission rates following outpatient visits, with Pearson correlation coefficients of 0.63 and 0.45, respectively. The top five disease categories online were psychiatric disorders of neurological origins, epilepsy, movement disorders, cerebrovascular disease and dizziness and headache; the top five offline categories were psychiatric disorders of neurological origins, cerebrovascular disease, dizziness and headache, neurological complications of medical diseases and movement disorders. Conclusion The hospital’s online business volume increased significantly, with a certain impact on offline volume, but no significant effect on the main outpatient diagnoses. In the future, online outpatient services can be optimized in terms of the service process and content for first-time patients, patients with co-morbidities or undifferentiated diseases, and elderly patients, to build a continuity management system for the whole process of outpatient care.

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1. 薛以锋, 赵琦, 王艳莉, 等. 移动互联网医院云平台的设计与实现. 中国数字医学, 2015, 10(1): 94-95, 111.
2. 姚刚, 葛帅, 苏宇, 等. 公立医院互联网医院服务体系建设探索与思考. 中国医院, 2022, 26(1): 6-8.
3. 张川, 贾小溪, 李卫红, 等. 智慧门诊诊疗服务模式构建与应用研究. 中国医院, 2022, 26(7): 88-90.
4. 王立泽, 欧阳涛, 范照青, 等. 新型冠状病毒肺炎疫情下肿瘤专科医院临床科室线上诊疗系统的应用. 中国医院管理, 2020, 40(11): 76-79.
5. 赵子衿, 李贤华, 陈尔真, 等. 上海市互联网医院运行管理机制与标准化建设探索. 中国医院管理, 2023, 43(2): 64-67.
6. 张烨, 黄劼, 王蕾, 等. 我国互联网医院发展现状. 中国现代医生, 2022, 60(6): 163-166.
7. 姚峥, 汉业旭, 孙雪梅, 等. 防控重大传染性疾病期间开展互联网诊疗服务实践与体会. 中国医院, 2021, 25(8): 78-80.
8. 田振, 刘智, 唐磊, 等. 线上门诊在某肿瘤专科医院的应用实践及分析. 中国医院, 2022, 26(1): 74-76.
9. 田振, 张金, 唐磊, 等. 门诊患者就诊等候现况分析与对策研究. 中国卫生标准管理, 2019, 10(12): 29-32.
10. 田振, 刘智, 唐磊, 等. 肿瘤专科医院基于互联网技术的初诊就医效果分析. 中华医院管理杂志, 2021, 37(10): 815-818.
11. 何英剑, 欧阳涛, 范照青, 等. 医院临床科室线上初诊咨询系统优势和随访结果分析. 中国医院管理, 2021, 41(11): 73-75.
12. 张新童, 姜劲, 张研, 等. 常见病互联网首诊的实现逻辑与适宜病种分析. 中华医院管理杂志, 2024, 40(4): 292-297.
13. Slattery BW, O'Connor L, Haugh S, et al. Prevalence, impact and cost of multimorbidity in a cohort of people with chronic pain in Ireland: a study protocol. BMJ Open, 2017, 7(1): e012131.
14. 邱艳, 任文, 刘颖, 等. 综合性医院全科线上-线下门诊就诊情况分析. 中华医院管理杂志, 2018, 34(7): 552-555.
15. 张含之, 韩一平, 金花, 等. 社区全科医生对门诊未分化疾病的诊治现况及城郊对比研究. 中国全科医学, 2021, 24(7): 855-863.
16. Rady A, Alamrawy R, Ramadan I, et al. Alexithymia among patients with unexplained physical symptoms. European Psychiatry, 2021, 64(Suppl 1): S249-S250.
17. 戚淼杰, 韩优莉. 医院就诊患者在线医疗使用现状及其相关因素研究—基于北京市三级医院门诊患者的调查. 中国卫生政策研究, 2019, 12(7): 70-74.
18. 周英达, 卓书雄, 金花, 等. 上海市社区全科医生对未分化疾病认知度和诊疗能力的自我评价研究. 中国全科医学, 2021, 24(31): 3979-3985.
19. Kaur T, Ranjan P, Sarkar S, et al. Psychological interventions for medically unexplained physical symptoms: a systematic review and meta-analysis. Gen Hosp Psychiatry, 2022, 77: 92-101.
20. 苏宇, 李刚, 燕政寰. 互联网医疗促进诊疗模式变革的实践与分析. 中华医院管理杂志, 2020, 36(9): 726-729.
21. Arts M. Somatic comorbidity and physical frailty in elderly with medically unexplained symptoms. European Psychiatry, 2022, 65(S1): S478.
22. 李疆, 方鹏骞, 傅新巧. 某大型公立医院互联网医院患者线上就诊体验分析. 中华医院管理杂志, 2023, 39(11): 835-840.
23. 秦涵书, 肖明朝, 胡磊. 互联网医疗服务适老化研究. 中国医院, 2022, 26(8): 47-49.

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