Moore C G, Wilson-Witherspoon P, Probst J C
Department of Family and Preventive Medicine, University of South Carolina School of Medicine, Columbia 29203, USA.
Fam Med. 2001 Jul-Aug;33(7):522-7.
When patients fail to appear for scheduled appointments, the flow of patient care is interrupted, and clinic productivity declines. This study investigated the impact of failed appointments on a clinic by measuring time and money lost after taking into account same-day treatment patients (walk-ins).
Schedule information was retrieved for 4,055 visits over 20 business days. Data were collected on appointment status (show, no-show, cancel, walk-in), time allocated for the appointment, charges for visit, date and time of the visit, and other appointment information.
No-shows and cancellations represented 31.1% of scheduled appointments and 32.2% of scheduled time. Rates of failed appointments varied by type of provider, patient demographics, and patient status (new versus established). Walk-in patients replaced 61.0% of failed appointments but only 42.4% of the time blocked for those appointments. Walk-in visits generated 89.5% of the charges associated with scheduled visits. Over the course of a year, total revenue shortfalls could range from 3% to 14% of total clinic income.
Failed appointments pose financial as well as administrative problems for residency practices. Proactive reminder systems are needed to promote patient attendance.
当患者未按预约前来就诊时，患者护理流程会被中断，诊所的工作效率也会下降。本研究通过测量在考虑当日就诊患者（即未预约直接前来就诊者）后所损失的时间和金钱，调查了未如约就诊对一家诊所的影响。
检索了20个工作日内4055次就诊的日程安排信息。收集的数据包括预约状态（就诊、未就诊、取消、未预约直接前来就诊）、预约分配时间、就诊费用、就诊日期和时间以及其他预约信息。
未就诊和取消预约的情况占预约就诊的31.1%，占预约时间的32.2%。未如约就诊的发生率因提供者类型、患者人口统计学特征和患者状态（新患者与老患者）而异。未预约直接前来就诊的患者填补了61.0%的未如约就诊空缺，但只占用了这些预约所空出时间的42.4%。未预约直接前来就诊产生的费用占与预约就诊相关费用的89.5%。在一年的时间里，诊所总收入短缺可能占诊所总收入的3%至14%。
未如约就诊给住院医师培训实践带来了财务和管理方面的问题。需要积极的提醒系统来提高患者的就诊率。
