Forjuoh S N, Averitt W M, Cauthen D B, Couchman G R, Symm B, Mitchell M
Department of Family Practice, Scott & White Memorial Hospital, and Texas A&M University System Health Science Center College of Medicine, Temple 76504, USA.
J Am Board Fam Pract. 2001 Jul-Aug;14(4):259-65.
Inadequate access to their primary care physician remains a major reason for patient dissatisfaction in ambulatory care. The concept of open-access appointment scheduling has been found to accommodate patients' urgent health care needs while providing continuous, routine care. We describe the development of a demand prediction grid for future appointments, compare it with one developed by Kaiser Permanente, and compare the predictions with actual appointments made and held in our clinic.
Using adjusted 1999 appointments based on historical data for the Scott & White Killeen Clinic (> 75,000 annual appointments; 13 family physicians), we computed appointment predictions for calendar year 2000 by day of the week and by month of the year. We then compared our predictions with those of Kaiser and actual appointments for the first half of 2000.
Our data and the Kaiser data agreed on the day of week, but they were different for the summer and winter months. Overall, actual appointments made and held at our clinic for January through June 2000 were within 6% of the predictions. Appointments for January and February were 18% and 4% more than the predictions, respectively, while appointments for March were 3% less than the predictions. Appointments for April through June were 3% to 7% more than the predictions. Few daily variations were observed between actual appointments and predictions.
We conclude that the Kaiser data might be tempered by a different climate, underscoring the need for each practice to develop its own demand prediction grid. That our actual appointments were 6% more than predicted overall but fluctuated month by month reemphasizes the need for continuous monitoring of the adjustment factor for prediction.
患者难以预约到初级保健医生仍然是门诊患者不满的主要原因。研究发现，开放预约排班的理念能够满足患者紧急的医疗需求，同时提供持续的常规护理。我们描述了一个用于未来预约的需求预测网格的开发过程，将其与凯撒医疗集团开发的预测网格进行比较，并将预测结果与我们诊所实际进行并完成的预约进行比较。
利用斯科特与怀特基林诊所1999年的预约历史数据（每年预约量超过75,000次；13名家庭医生）进行调整后，我们按星期几和一年中的月份计算了2000日历年的预约预测。然后，我们将我们的预测结果与凯撒医疗集团的预测结果以及2000年上半年的实际预约情况进行了比较。
我们的数据和凯撒医疗集团的数据在星期几方面是一致的，但在夏季和冬季月份有所不同。总体而言，我们诊所2000年1月至6月实际进行并完成的预约量在预测值的6%以内。1月和2月的预约量分别比预测值多18%和4%，而3月的预约量比预测值少3%。4月至6月的预约量比预测值多3%至7%。实际预约与预测之间几乎没有观察到每日变化。
我们得出结论，凯撒医疗集团的数据可能受到不同气候的影响，这凸显了每个医疗机构制定自己的需求预测网格的必要性。我们的实际预约量总体上比预测值多6%，但逐月波动，这再次强调了持续监测预测调整因素的必要性。
