通过文件资料回顾和上海市案例研究,了解在自由就诊模式下开展预约诊疗服务工作存在的问题与挑战,集中体现在预约诊疗服务平台的发展缺乏可持续性,预约内容和途径的拓展受到现实因素的制约,“实名制预约”和“预约优先”的落实面临挑战,当前预约诊疗服务工作自身也存在局限性.建议通过拓展预约方式、建立费用约束机制和利用服务规则来强化预约诊疗服务管理,同时积极开展公众宣传教育和发挥改革举措之间的协同作用.%The problems and challenges of outpatient appointment services against the background of hospitals were selected freely by patients through documents review and case study in Shanghai. The main findings included the lack of sustainability of developing the outpatient appointment services platform, and the expansion of content. Means of appointment was restrained by some reality factors, and implementing "real-name appointment" and "priority right with appointment" were very difficult. Suggestions include expanding the means of appointment, developing cost constraint mechanism, strengthening management of appointment rules, and actively carrying out public education and. Playing a synergy effect between outpatient appointment services and other health reform initiatives.
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