Husain-Gambles Mahvash, Neal Richard D, Dempsey Owen, Lawlor Debbie A, Hodgson Jim
Department of General Practice, University Of Leeds College of Medicine, Leeds, UK.
Br J Gen Pract. 2004 Feb;54(499):108-13.
The issue of missed appointments in primary care is important for patients and staff. Little is known about how missed appointments, and the people who miss them, are managed in primary care, or about effective strategies for managing missed appointments.
To understand the perceptions of primary care staff as to why patients miss appointments, to determine how these perceptions influence their management, and to explore the merit of different management strategies.
A postal questionnaire survey and focus group interviews.
General practices in Yorkshire.
Missed appointments were regarded as an important problem. Patient factors rather than practice factors were perceived as most important in causing missed appointments. Intervention strategies appeared to be driven by perceptions of why patients miss appointments. Negative attitudes, embodied in terms such as "offenders" to refer to those who missed appointments were prevalent, and favoured intervention strategies included punishing the patient in some way. Receptionists believed that general practitioners should address the issue of the missed appointment with the patient. General practitioners felt guarded about addressing missed appointments with their patients in case it affected the doctor-patient relationship.
People who miss appointments were viewed negatively by primary care staff, and most of the reasons for missed appointments were focused on patients. These beliefs underpinned intervention strategies aimed mainly at punishment. Since there is no evidence base concerning interventions that are effective in reducing missed appointments, these negative attitudes may not be beneficial to staff or their patients.
基层医疗中患者爽约的问题对患者和工作人员都很重要。对于基层医疗中如何处理爽约情况以及爽约的人，以及处理爽约的有效策略，人们了解得很少。
了解基层医疗工作人员对患者爽约原因的看法，确定这些看法如何影响他们的处理方式，并探讨不同处理策略的优点。
邮寄问卷调查和焦点小组访谈。
约克郡的全科诊所。
爽约被视为一个重要问题。在导致爽约的原因中，患者因素而非诊所因素被认为是最重要的。干预策略似乎是由对患者爽约原因的看法驱动的。用“违规者”等措辞来指代爽约者的负面态度很普遍，受欢迎的干预策略包括以某种方式惩罚患者。接待员认为全科医生应该与患者解决爽约问题。全科医生对接待员与患者解决爽约问题持谨慎态度，以防影响医患关系。
基层医疗工作人员对爽约者持负面看法，且爽约的大多数原因都集中在患者身上。这些观念支撑了主要旨在惩罚的干预策略。由于没有关于有效减少爽约的干预措施的证据基础，这些负面态度可能对工作人员或他们的患者都没有好处。
