Mitchell Alex J, Selmes Thomas
Department of Liaison Psychiatry, Leicester General Hospital, UK.
Psychiatr Serv. 2007 Jun;58(6):868-71. doi: 10.1176/ps.2007.58.6.868.
Missed appointments are common in psychiatry. Nonattendance at the initial appointment may have different prognostic significance than nonattendance at subsequent appointments. This study examined the frequency of missed appointments among 9,511 initial outpatient appointments and 7,700 follow-up appointments across ten psychiatric subspecialties in a publicly funded mental health service in the United Kingdom.
The pooled missed appointment rate was 15.9%, higher than in previous studies on primary and secondary care attendance in the United Kingdom. Nonattendance was lowest on Fridays, in winter months, and in geriatric psychiatry and highest for substance abuse services and in community psychiatry. In most services, attendance improved after the initial appointment, but in psychosomatic medicine and geriatric psychiatry this pattern was reversed.
There was a low rate of missed appointments in geriatric psychiatry, rehabilitation psychiatry, cognitive-behavioral therapy, and psychosocial medicine. A high nonattendance rate was found among persons with drug and alcohol difficulties and to a lesser extent in general adult psychiatry. Future studies should consider initial and follow-up appointments as distinct.
预约失约在精神病学领域很常见。初次预约未就诊与后续预约未就诊可能具有不同的预后意义。本研究调查了英国一项公共资助心理健康服务中十个精神科亚专业的9511例初次门诊预约和7700例随访预约中的失约频率。
汇总的失约率为15.9%，高于此前英国关于初级和二级医疗就诊情况的研究。周五、冬季月份、老年精神病学领域的失约率最低，物质滥用服务和社区精神病学领域的失约率最高。在大多数服务中，初次预约后的就诊率有所提高，但在身心医学和老年精神病学中，这种模式则相反。
老年精神病学、康复精神病学、认知行为疗法和心理社会医学领域的失约率较低。在有药物和酒精问题的人群中，失约率较高，在普通成人精神病学领域失约率相对较低。未来的研究应将初次预约和随访预约视为不同情况。
