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Background Follow-up is a necessary step in the management of chronic disease patients. Cloud follow-up as a new form of follow-up may improve the quality of follow-up. However, there is currently a lack of patient-oriented evaluation tools for cloud follow-up service quality. Objective To develop a scale for evaluating the service experience of chronic disease patients in cloud follow-up and to examine its reliability and validity, in order to provide a tool for evaluating the quality of cloud follow-up services. Methods Guided by the service quality evaluation model, the scale was developed by using methods including literature review, semi-structured interview, expert consultation. During August to October 2022, a survey was conducted among chronic disease patients (n=480) discharged from a tertiary hospital and lived under the network of a community service center in Hangzhou, China. Item analysis and tests of reliability and validity were test on the developed scale. Results The developed scale for evaluating the service experience of chronic disease patients in cloud follow-up had 37 items distributed in 5 dimensions. Patients' perceptions and expectations to each item were evaluated simultaneously. The overall Cronbach's α coefficient of the developed scale was 0.962, with split-half reliability of 0.732 and test-retest reliability of 0.844. The content validity index of the scale was 0.980. The correlation coefficient between the scale and satisfaction scores was 0.754 (P

BackgroundIt's necessary to pay urgent attention to the quality of the integration of medical treatment-nursing-rehabilitation in the service promotion process, especially the evaluation from the perspective of patients is lacking.ObjectiveTo investigate patients' perspective on the quality of integration of medical treatment-nursing-rehabilitation for chronic disease patients in the community in Hangzhou, to provide help for improving the quality of such services.MethodsA questionnaire survey was conducted from June to September 2020 with 550 chronic disease patients selected by convenient sampling method from the service population of 10 community health centers in five major urban districts (Jianggan, Gongshu, Xihu, Shangcheng, and Xiacheng Districts) of Hangzhou, Zhejiang Province, for collecting their general demographic information, and diseases and treatment-related information, as well as experience of receiving integration of medical treatment-nursing-rehabilitation (using the Chinese version of SERVQUAL Scale consisting of effectiveness, responsiveness, reliability, communication and empathy) .ResultsA total of 525 (95.5%) of the respondents returned responsive questionnaire. Among 525 patients with chronic diseases, 165 (31.4%) were satisfied with integration of medical treatment-nursing-rehabilitation. The patients' total average score of the service perception (5.14±0.44) did not reach their expected level (6.80±0.01) . From high to low the scores of each dimension were reliability (5.69±0.87) , effectiveness (5.43±0.85) , empathy (5.13±1.81) , communication (4.86±1.53) , responsiveness (4.77±0.98) . There was tiny difference among the scores of each dimension of the service expectation. The largest gap between perception and expectation was responsiveness (-2.01±0.14) and the smallest was reliability (-1.11±0.17) . Excluding the 20 "other" respondents in the satisfaction survey, a total of 505 respondents were analyzed by Spearman rank correlation. The results showed that the patients' service satisfaction was positively correlated with the service perception level in terms of total average score (rs=0.741, P

The problem of health and pension in an aging society is becoming increasingly acute. Under the promotion of Chinese policy of combining medical care with nursing care and the hierarchical diagnosis and treatment system. Hangzhou City, Zhejiang Province, has pioneered integrated medical-elderly-nursing services to meet the healthcare needs of an aging society. The initial effects of the services have been shown, but there are so many influencing factors associated with the delivery. And the relevant influencing factors are lack of systematic and comprehensive analysis. Therefore, summarizing the factors associated with the implementation of the services and described them in terms of five aspects (intervention characteristics, outer setting, inner setting, characteristics of individuals, process) with the help of Consolidated Framework for Implementation Research. The major facilitators to implementing IMSs were as follows: diversified and individualized services, close and long-term cooperation between the healthcare institution delivering IMSs and other institutions in the regional medical consortium, clear determination of the duties of each member in the service team, incentives from hospital or other institutions. The major barriers were: lack of flexibility and ignoring individual characteristics in delivering some services, for example, health management; inadequate levels of diagnosis and treatment; insufficient workers, equipment, and drugs.