Kavanagh K T, Smith T R, Golden G S, Tate N P, Hinkle W G
Boling Center for Developmental Disabilities, University of Tennessee, Memphis.
J Health Soc Policy. 1991;2(3):85-102. doi: 10.1300/J045v02n03_06.
Parents of pediatric patients attending regional otologic medical clinics were given a questionnaire to document family risk factors predictive of poor appointment attendance, and to determine barriers which caused non-attendance of medical appointments. Family risk factors which affected clinic attendance were studied using univariate and multivariate analyses. Univariate analyses revealed all factors except patients' sex and family size to be correlated with attendance. However, multivariate analysis revealed that parental age (p less than 0.0153), ownership of car (p less than 0.0012), parental education (p less than 0.0048), and age of patient (p less than 0.0023) were major predictors of clinic attendance. Although ownership of a car was a major independent factor, it was highly correlated with parental age and parental education and only shown to be significant in the subset of patients not having access to public transportation. The identified parental factors which affect pediatric health care delivery underscores the importance of family centered case management in promoting the health care of children and casts doubt on the effectiveness of interventions which are solely centered on the patient or are designed to mitigate only one of these factors.
前往地区耳科医疗诊所就诊的儿科患者的家长收到了一份问卷，以记录预测预约就诊情况不佳的家庭风险因素，并确定导致未按时就诊的障碍。使用单变量和多变量分析研究了影响诊所就诊的家庭风险因素。单变量分析显示，除患者性别和家庭规模外，所有因素均与就诊情况相关。然而，多变量分析显示，父母年龄（p<0.0153）、汽车拥有情况（p<0.0012）、父母教育程度（p<0.0048）和患者年龄（p<0.0023）是诊所就诊情况的主要预测因素。虽然汽车拥有情况是一个主要的独立因素，但它与父母年龄和父母教育程度高度相关，并且仅在无法使用公共交通工具的患者子集中显示出显著性。所确定的影响儿科医疗服务提供的父母因素强调了以家庭为中心的病例管理在促进儿童医疗保健方面的重要性，并对仅以患者为中心或仅旨在减轻这些因素之一的干预措施的有效性提出了质疑。
