Sonnenberg Amnon
Department of Gastroenterology, Portland VA Medical Center, Portland, Oregon 97239, USA.
Gastrointest Endosc. 2009 Mar;69(3 Pt 2):710-5. doi: 10.1016/j.gie.2008.09.052.
Because nonattendance of outpatients scheduled for GI endoscopy is unavoidable, a frequently recommended solution involves overbooking patient appointments.
To provide a set of numerical guidelines of how to overbook patients scheduled for endoscopy.
Cost-benefit analysis using stochastic modeling to estimate the total number of endoscopy appointments (including overbooking) that maximize the expected benefit from endoscopy.
Subjects scheduled for GI endoscopy.
The number of endoscopies that should be scheduled under various scenarios of patient attendance rates, the number of available endoscopy slots, and the cost impact of missed appointments.
Overbooking can increase the expected benefit but never quite reaches the benefit that would be achieved, if all patients were perfectly reliable in meeting their scheduled appointments. The expected benefit of overbooking always comes to lie between the low benefit without overbooking and the high benefit associated with perfectly reliable patients. The less reliable the patient population, the more overbooking needs to take place. Overbooking should also expand with a decreasing cost impact of overbooked endoscopies. Overbooking is most beneficial in large endoscopy units. This article provides a table with a large set of numerical examples for different scenarios of overbooking that cover endoscopy units of diverse sizes and patient attendance rates.
The analysis does not take into account individual patient characteristics that may affect attendance rates.
This analysis yields a set of estimates for overbooking that can be readily applied to a large variety of endoscopic units.
由于安排进行胃肠内镜检查的门诊患者爽约难以避免，一种常被推荐的解决方案是对患者预约进行超额预订。
提供一套关于如何对安排内镜检查的患者进行超额预订的数值指南。
采用随机模型进行成本效益分析，以估计能使内镜检查预期效益最大化的内镜检查预约总数（包括超额预订）。
安排进行胃肠内镜检查的受试者。
在不同患者出勤率情况下应安排的内镜检查数量、可用内镜检查时段数量以及预约未到所产生的成本影响。
超额预订可增加预期效益，但永远无法完全达到所有患者都能完全按时赴约时所能实现的效益。超额预订的预期效益总是介于无超额预订时的低效益和与完全可靠患者相关的高效益之间。患者群体越不可靠，就越需要进行超额预订。随着超额预订内镜检查的成本影响降低，超额预订也应增加。超额预订在大型内镜检查科室最为有益。本文提供了一个表格，其中包含大量不同超额预订情况的数值示例，涵盖了不同规模的内镜检查科室和患者出勤率。
该分析未考虑可能影响出勤率的个体患者特征。
该分析得出了一组超额预订估计值，可轻松应用于各种内镜检查科室。
