【摘要】 目的 从住院患者角度出发，了解重庆市县级公立医院智慧医疗服务质量现状，为同级医院发展智慧医疗提供参考。方法 2021年10—11月，采用多阶段分层随机抽样选取9家县级公立医院的住院患者，结合SERVQUAL模型进行问卷调查，测评住院患者对智慧医疗服务的期望、感知，调查内容包含可靠性、保证性、响应性、经济性、移情性、有形性6个维度，共24个条目，采用成对样本t检验比较期望与感知的差值，计算服务质量得分。采用t检验，秩和检验、方差分析和多元线性回归分析服务质量的影响因素。结果 六个维度平均得分-0.58分(t=-19.037,P<0.001),六个维度得分依次为保证性-0.40分(t=-11.021,P<0.001)、可靠性-0.53分(t=-15.130,P<0.001)、响应性-0.56分(t=-14.859,P<0.001)、有形性-0.57分(t=-14.103,P<0.001)、移情性-0.65分(t=-17.021,P<0.001)与经济性-0.79分(t=-16.600,P<0.001)。成对样本t检验显示，24个条目的服务质量得分均为负数。住院患者对智慧医疗服务质量的期望与感受存在差异(P<0.001)。多因素回归显示，居住在外地(β=0.213, 95%CI:0.029～0.396),户口在农村(β=0.147, 95%CI:0.015～0.279),职业类型为办事人员(β=-0.325, 95%CI:-0.602～-0.048)、军人(β=-0.703, 95%CI:-1.363～-0.042)、无业/其他(β=-0.473, 95%CI:-0.771～-0.176),学历为大专(β=-0.187, 95%CI:-0.366～-0.009)的住院患者会影响智慧医疗服务质量评价。结论 住院患者对智慧医疗服务的期望与实际感受存在较大差距，且受到多种因素影响。建议在医疗费用、隐私保护、人文关怀、服务内容等方面改进。更多还原

【Abstract】 Objective To understand the current situation of the quality of smart healthcare services in county-level public hospitals in Chongqing from the perspective of inpatients, and to provide a reference for the development of smart healthcare at the same level of hospitals. Methods In October-November 2021, a questionnaire survey was conducted using a multi-stage stratified random sample of inpatients from nine county-level public hospitals, combined with the SERVQUAL model, to measure inpatients’ expectations and perceptions of smart healthcare services. The survey contained six dimensions of reliability, assurance, responsiveness, economy, empathy, and tangibility, with a total of 24 entries. A paired sample t-test was used to compare the difference between expectations and perceptions to calculate the service quality score. The t-test, rank sum test, ANOVA, and multiple linear regression were used to analyze the factors influencing service quality.Results The mean score of the six dimensions was-0.58(t=-19.037, P<0.001), the six dimension scores in the order of assurance-0.40(t=-11.021, P<0.001), reliability-0.53(t=-15.130, P<0.001), responsiveness-0.56(t=-14.859, P<0.001), Tangibility-0.57(t=-14.103, P<0.001), Empathy-0.65(t=-17.021, P<0.001) and Economy-0.79(t=-16.600, P<0.001). The paired samples t-test showed negative service quality scores for all 24 items. There was a difference between inpatient expectations and perceptions of the quality of smart healthcare services(P<0.001). Multiple linear regression showed that living outside the country(β=0.213, 95%CI:0.029 to 0.396), having a rural household(β=0.147, 95%CI:0.015 to 0.279), having an occupation type of clerical(β=-0.325, 95%CI:-0.602 to-0.048), military(β=-0.703, 95%CI:-1.363 to-0.042), unemployed/other(β=-0.473, 95%CI:-0.771 to-0.176), and inpatients with a college education(β=-0.187, 95%CI:-0.366 to-0.009) affect the evaluation of the quality of smart healthcare. Conclusion There is a large gap between inpatients’ expectations and actual feelings about smart healthcare services, and it is influenced by several factors. Improvements are recommended in the areas of medical costs, privacy protection, humanistic care, and service content.更多还原