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.

Citation： GUAN Qiaozhi, XIAO Shiwei, WEN Jin. 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, 2025, 25(10): 1157-1163. doi: 10.7507/1672-2531.202501122 Copy

1.	薛以鋒, 趙琦, 王艷莉, 等. 移動互聯網醫院云平臺的設計與實現. 中國數字醫學, 2015, 10(1): 94-95, 111.
2.	姚剛, 葛帥, 蘇宇, 等. 公立醫院互聯網醫院服務體系建設探索與思考. 中國醫院, 2022, 26(1): 6-8.
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4.	王立澤, 歐陽濤, 范照青, 等. 新型冠狀病毒肺炎疫情下腫瘤專科醫院臨床科室線上診療系統的應用. 中國醫院管理, 2020, 40(11): 76-79.
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9.	田振, 張金, 唐磊, 等. 門診患者就診等候現況分析與對策研究. 中國衛生標準管理, 2019, 10(12): 29-32.
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11.	何英劍, 歐陽濤, 范照青, 等. 醫院臨床科室線上初診咨詢系統優勢和隨訪結果分析. 中國醫院管理, 2021, 41(11): 73-75.
12.	張新童, 姜勁, 張研, 等. 常見病互聯網首診的實現邏輯與適宜病種分析. 中華醫院管理雜志, 2024, 40(4): 292-297.
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15.	張含之, 韓一平, 金花, 等. 社區全科醫生對門診未分化疾病的診治現況及城郊對比研究. 中國全科醫學, 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.
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18.	周英達, 卓書雄, 金花, 等. 上海市社區全科醫生對未分化疾病認知度和診療能力的自我評價研究. 中國全科醫學, 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.	蘇宇, 李剛, 燕政寰. 互聯網醫療促進診療模式變革的實踐與分析. 中華醫院管理雜志, 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, 方鵬騫, 傅新巧. 某大型公立醫院互聯網醫院患者線上就診體驗分析. 中華醫院管理雜志, 2023, 39(11): 835-840.
23.	秦涵書, 肖明朝, 胡磊. 互聯網醫療服務適老化研究. 中國醫院, 2022, 26(8): 47-49.

1. 薛以鋒, 趙琦, 王艷莉, 等. 移動互聯網醫院云平臺的設計與實現. 中國數字醫學, 2015, 10(1): 94-95, 111.
2. 姚剛, 葛帥, 蘇宇, 等. 公立醫院互聯網醫院服務體系建設探索與思考. 中國醫院, 2022, 26(1): 6-8.
3. 張川, 賈小溪, 李衛紅, 等. 智慧門診診療服務模式構建與應用研究. 中國醫院, 2022, 26(7): 88-90.
4. 王立澤, 歐陽濤, 范照青, 等. 新型冠狀病毒肺炎疫情下腫瘤專科醫院臨床科室線上診療系統的應用. 中國醫院管理, 2020, 40(11): 76-79.
5. 趙子衿, 李賢華, 陳爾真, 等. 上海市互聯網醫院運行管理機制與標準化建設探索. 中國醫院管理, 2023, 43(2): 64-67.
6. 張燁, 黃劼, 王蕾, 等. 我國互聯網醫院發展現狀. 中國現代醫生, 2022, 60(6): 163-166.
7. 姚崢, 漢業旭, 孫雪梅, 等. 防控重大傳染性疾病期間開展互聯網診療服務實踐與體會. 中國醫院, 2021, 25(8): 78-80.
8. 田振, 劉智, 唐磊, 等. 線上門診在某腫瘤專科醫院的應用實踐及分析. 中國醫院, 2022, 26(1): 74-76.
9. 田振, 張金, 唐磊, 等. 門診患者就診等候現況分析與對策研究. 中國衛生標準管理, 2019, 10(12): 29-32.
10. 田振, 劉智, 唐磊, 等. 腫瘤專科醫院基于互聯網技術的初診就醫效果分析. 中華醫院管理雜志, 2021, 37(10): 815-818.
11. 何英劍, 歐陽濤, 范照青, 等. 醫院臨床科室線上初診咨詢系統優勢和隨訪結果分析. 中國醫院管理, 2021, 41(11): 73-75.
12. 張新童, 姜勁, 張研, 等. 常見病互聯網首診的實現邏輯與適宜病種分析. 中華醫院管理雜志, 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. 邱艷, 任文, 劉穎, 等. 綜合性醫院全科線上-線下門診就診情況分析. 中華醫院管理雜志, 2018, 34(7): 552-555.
15. 張含之, 韓一平, 金花, 等. 社區全科醫生對門診未分化疾病的診治現況及城郊對比研究. 中國全科醫學, 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, 韓優莉. 醫院就診患者在線醫療使用現狀及其相關因素研究—基于北京市三級醫院門診患者的調查. 中國衛生政策研究, 2019, 12(7): 70-74.
18. 周英達, 卓書雄, 金花, 等. 上海市社區全科醫生對未分化疾病認知度和診療能力的自我評價研究. 中國全科醫學, 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. 蘇宇, 李剛, 燕政寰. 互聯網醫療促進診療模式變革的實踐與分析. 中華醫院管理雜志, 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, 方鵬騫, 傅新巧. 某大型公立醫院互聯網醫院患者線上就診體驗分析. 中華醫院管理雜志, 2023, 39(11): 835-840.
23. 秦涵書, 肖明朝, 胡磊. 互聯網醫療服務適老化研究. 中國醫院, 2022, 26(8): 47-49.

Chinese Journal of Evidence-Based Medicine

A comparative study of online and offline outpatient services in a large hospital—taking neurology department as an example

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