Knolhoff Joshua B, Djenic Brano, Hsu Chiu-Hsieh, Bouton Marcia E, Komenaka Ian K
Department of Surgery, Maricopa Medical Center, Phoenix, Arizona.
Arizona Cancer Center, University of Arizona, Tucson, Arizona; Mel and Enid Zuckerman Arizona College of Public Health, University of Arizona, Tucson, Arizona.
Am J Med Sci. 2016 Oct;352(4):337-342. doi: 10.1016/j.amjms.2016.07.003. Epub 2016 Jul 14.
Missed appointments are problematic because they occupy an appointment that could have been used by another patient and represent lost resources for the hospital system. The objective of this study was to determine patient-related factors associated with missed appointments.
Totally, 1,624 patients were seen from January 14, 2010 to January 16, 2012. Sociodemographic variables were collected including health literacy assessment, electronic medical record system-collected scheduled appointments and missed appointments for each patient. Patients were also asked for their preferred method of contact.
From January 1, 2009 to January 16, 2012 the 1,624 patients had 21,648 scheduled appointments in the hospital system. Overall 3,633 (16.8%) of the appointments were missed. Insurance status, income, education and primary language were not significant predictors for missed appointments. Limited health literacy was associated with increased rate of missed appointments (adequate health literacy 13.4% versus limited health literacy 17.2%, P = 0.0009). Current smokers had higher rates of missed appointments than nonsmokers (18.5% versus 16.1%, P = 0.025). Patients who underwent screening mammography were also less likely to miss appointments (odds ratio = 0.78, P < 0.0001). The preferred method of contact was via mobile phone; however, this was only 42%.
Patients with limited health literacy and current smokers had higher rates of missed appointments. In addition, patients who were compliant with screening mammography were also more likely to be compliant with appointments. Appointment reminders should be kept simple to accommodate the rapidly growing population with limited health literacy.
失约问题严重,因为它们占用了本可被其他患者使用的预约时段,对医院系统而言意味着资源损失。本研究的目的是确定与失约相关的患者因素。
2010年1月14日至2012年1月16日期间,共诊治了1624名患者。收集了社会人口统计学变量,包括健康素养评估、电子病历系统记录的每位患者的预约安排和失约情况。还询问了患者偏好的联系方式。
2009年1月1日至2012年1月16日期间,这1624名患者在医院系统中有21648次预约。总体而言,3633次(16.8%)预约失约。保险状况、收入、教育程度和母语并非失约的显著预测因素。健康素养有限与失约率增加相关(健康素养良好者为13.4%,健康素养有限者为17.2%,P = 0.0009)。当前吸烟者的失约率高于非吸烟者(18.5%对16.1%,P = 0.025)。接受乳腺钼靶筛查的患者也不太可能失约(比值比 = 0.78,P < 0.0001)。偏好的联系方式是手机;然而,这一比例仅为42%。
健康素养有限的患者和当前吸烟者的失约率较高。此外,遵守乳腺钼靶筛查的患者也更有可能遵守预约。预约提醒应保持简单,以适应健康素养有限的快速增长人群。