Drewek Rupali, Mirea Lucia, Adelson P David
Author Affiliations: Sleep Disorders Center, Department of Pediatric Pulmonology (Dr Drewek), and Department of Research (Dr Mirea), and Barrow Neurological Institute and Neurosurgery, (Dr Adelson) Phoenix Children's Hospital, Arizona.
Health Care Manag (Frederick). 2017 Jan/Mar;36(1):4-9. doi: 10.1097/HCM.0000000000000148.
High rates of no-shows in outpatient clinics are problematic for revenue and for quality of patient care. Longer lead time to appointment has variably been implicated as a risk factor for no-shows, but the evidence within pediatric clinics is inconclusive. The goal of this study was to estimate no-show rates and test for association between appointment lead time and no-show rates for new and follow-up patients. Analyses included 534 new and 1920 follow-up patients from pulmonology and gastroenterology clinics at a freestanding children's hospital. The overall rate of no-shows was lower for visits scheduled within 0 to 30 days compared with 30 days or more (23% compared with 47%, P < .0001). Patient type significantly modified the association of appointment lead time; the rate of no-shows was higher (30%) among new patients compared with (21%) follow-up patients with appointments scheduled within 30 days (P = .004). For appointments scheduled 30 or more days' lead time, no-show rates were statistically similar for new patients (46%) and follow-up patients (0.48%). Time to appointment is a risk factor associated with no-shows, and further study is needed to identify and implement effective approaches to reduce appointment lead time, especially for new patients in pediatric subspecialties.
门诊诊所的高失约率对收入和患者护理质量都存在问题。预约前较长的准备时间一直被认为是失约的一个风险因素，但儿科诊所的相关证据尚无定论。本研究的目的是估计失约率，并测试新患者和复诊患者的预约准备时间与失约率之间的关联。分析纳入了一家独立儿童医院的肺病科和胃肠病科诊所的534名新患者和1920名复诊患者。与预约时间在30天或更长时间的患者相比，预约时间在0至30天内的患者总体失约率更低（分别为23%和47%，P < .0001）。患者类型显著改变了预约准备时间与失约率之间的关联；预约时间在30天内的新患者失约率（30%）高于复诊患者（21%）（P = .004）。对于预约准备时间为30天或更长时间的患者，新患者（46%）和复诊患者（48%）的失约率在统计学上相似。预约时间是与失约相关的一个风险因素，需要进一步研究以确定和实施有效的方法来缩短预约准备时间，特别是对于儿科专科的新患者。
