Kheirkhah Parviz, Feng Qianmei, Travis Lauren M, Tavakoli-Tabasi Shahriar, Sharafkhaneh Amir
Office of Performance Improvement, University of Texas MD Anderson Cancer Center, Houston, TX, USA.
Industrial Engineering Department, University of Houston, Houston, TX, USA.
BMC Health Serv Res. 2016 Jan 14;16:13. doi: 10.1186/s12913-015-1243-z.
Patients not attending to clinic appointments (no-show) significantly affects delivery, cost of care and resource planning. We aimed to evaluate the prevalence, predictors and economic consequences of patient no-shows.
This is a retrospective cohort study using administrative databases for fiscal years 1997-2008. We searched administrative databases for no-show frequency and cost at a large medical center. In addition, we estimated no-show rates and costs in another 10 regional hospitals. We studied no-show rates in primary care and various subspecialty settings over a 12-year period, the monthly and seasonal trends of no-shows, the effects of implementing a reminder system and the economic effects of missed appointments.
The mean no-show rate was 18.8% (2.4%) in 10 main clinics with highest occurring in subspecialist clinics. No-show rate in the women clinic was higher and the no-show rate in geriatric clinic was lower compared to general primary care clinic (PCP). The no-show rate remained at a high level despite its reduction by a centralized phone reminder (from 16.3% down to 15.8%). The average cost of no-show per patient was $196 in 2008.
Our data indicates that no-show imposed a major burden on this health care system. Further, implementation of a reminder system only modestly reduced the no-show rate.
患者未按预约前来就诊（爽约）对医疗服务的提供、医疗成本及资源规划均有显著影响。我们旨在评估患者爽约的发生率、预测因素及经济后果。
这是一项利用1997 - 2008财年行政数据库进行的回顾性队列研究。我们在一个大型医疗中心的行政数据库中搜索爽约频率及成本。此外，我们还估算了另外10家地区医院的爽约率及成本。我们研究了12年间初级保健及各类专科门诊的爽约率、爽约的月度和季节趋势、实施提醒系统的效果以及预约未就诊的经济影响。
10家主要诊所的平均爽约率为18.8%（2.4%），专科门诊的爽约率最高。与普通初级保健诊所（PCP）相比，妇科诊所的爽约率较高，老年科诊所的爽约率较低。尽管通过集中电话提醒使爽约率有所降低（从16.3%降至15.8%），但仍处于较高水平。2008年每位患者爽约的平均成本为196美元。
我们的数据表明，爽约给该医疗系统带来了重大负担。此外，实施提醒系统仅适度降低了爽约率。
