目的　通过评价一二级医院门诊医疗服务过程质量 ,为领导改善门诊质量提供决策依据。方法　采用模拟病人法对上海市区一二级医院各 2 0所门诊医疗服务进行调研。结果　通过模拟病人的 480次调查中 ,对医德的总体满意率为 5 8 75 % ,门诊医德医疗服务过程质量总体评价服从正态分布 ,一级医院平均得分 6 7 38,平均就诊时间和费用分别为 16 6 2分和 132 0 2元 ;二级医院平均得分 6 7 43,平均就诊时间和费用分别为 2 2 38分和 12 4 37元。影响质量的是疾病类型和诊疗时间 ,估计值 (bi)分别为 0 6 36 5、0 2 970。而影响医疗费用的主要是疾病类型 ,估计值 (bi)y - 2 9995。结论　一二级医院门诊医疗服务过程质量基本达到规范化要求 ,但仍需提高 Objective To provide a decision-making basis for leaders to improve the quality of outpatient services by evaluating the quality of outpatient medical services at the Level 1 and Level 2 hospitals. METHODS: A total of 20 outpatient medical services at grade one and two hospitals in Shanghai were investigated using the simulated patient method. Results In the 480 simulated surveys of patients, the overall satisfaction rate for medical ethics was 58.75%. The overall evaluation of the quality of medical services for outpatient medical services obeyed the normal distribution. The average score of primary hospitals was 6 7 38. The average time and cost of medical visits were It was 16 62 points and 132 0 2 yuan; the average score of secondary hospitals was 6 7 43; the average visit time and expenses were 2 2 38 points and 12 4 37 yuan respectively. What affected the quality was the type of disease and the time of diagnosis and treatment. The estimated values ​​(bi) were 0 6 36 5 and 0 2 970, respectively. The main types of illness affecting medical expenses are estimates (bi)y - 2995. Conclusion The quality of outpatient medical services in grade 1 and 2 hospitals basically meets the standardization requirements, but it still needs to be improved.