基于Kano模型的区县公立医院智慧医疗服务优化研究

Research on Smart Healthcare Service Optimization in County-Level Public Hospitals Based on the Kano Model

摘要: 目的：基于Kano模型识别重庆市区县公立医院患者对智慧医疗服务的需求属性，并提出分层优化策略。方法：采用分层多阶段抽样，于2025年12月至2026年1月在重庆市三大功能区各选取2家区县公立医院，每院计划调查100名患者；通过自制问卷收集资料，运用Kano模型和Better-Worse系数进行分析。结果：有效问卷578份，24项需求中必备需求9项、期望需求7项、魅力需求6项、无差别需求2项；“在线公示信息丰富准确”“知情同意与信息告知”“信息明确流程简单”位于重点优化区。结论：区县公立医院应优先守住信息真实性、流程效率、隐私与支付安全等服务底线，重点提升信息公开、知情告知和流程指引，并结合远程会诊、智能提醒等技术分阶段发展增值服务。

Abstract: Objective: This study used the Kano model to identify the demand attributes of smart healthcare services among patients in district and county-level public hospitals in Chongqing and proposed tiered optimization strategies. Methods: A stratified multistage sampling method was used. From December 2025 to January 2026, two district and county-level public hospitals were selected from each of Chongqing’s three major functional zones, with 100 patients planned for investigation at each hospital. Data were collected using a self-designed questionnaire and analyzed using the Kano model and Better–Worse coefficients. Results: A total of 578 valid questionnaires were obtained. Among the 24 service demands, 9 were classified as must-be needs, 7 as one-dimensional needs, 6 as attractive needs, and 2 as indifferent needs. “Rich and accurate online disclosure of information”, “informed consent and information notification”, and “clear information and simple procedures” were identified as priority areas for improvement. Conclusion: District and county-level public hospitals should first ensure the fundamental standards of information authenticity, process efficiency, privacy protection, and payment security. They should focus on improving information disclosure, informed notification, and process guidance, while developing value-added services—such as remote consultation and intelligent reminders—in stages through the application of relevant technologies.