Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts.
Harvard Medical School, Boston, Massachusetts.
J Am Coll Radiol. 2018 May;15(5):713-720. doi: 10.1016/j.jacr.2018.01.023. Epub 2018 Mar 2.
The aim of this study was to investigate the impact of wait days (WDs) on missed outpatient MRI appointments across different demographic and socioeconomic factors.
An institutional review board-approved retrospective study was conducted among adult patients scheduled for outpatient MRI during a 12-month period. Scheduling data and demographic information were obtained. Imaging missed appointments were defined as missed scheduled imaging encounters. WDs were defined as the number of days from study order to appointment. Multivariate logistic regression was applied to assess the contribution of race and socioeconomic factors to missed appointments. Linear regression was performed to assess the relationship between missed appointment rates and WDs stratified by race, income, and patient insurance groups with analysis of covariance statistics.
A total of 42,727 patients met the inclusion criteria. Mean WDs were 7.95 days. Multivariate regression showed increased odds ratio for missed appointments for patients with increased WDs (7-21 days: odds ratio [OR], 1.39; >21 days: OR, 1.77), African American patients (OR, 1.71), Hispanic patients (OR, 1.30), patients with noncommercial insurance (OR, 2.00-2.55), and those with imaging performed at the main hospital campus (OR, 1.51). Missed appointment rate linearly increased with WDs, with analysis of covariance revealing underrepresented minorities and Medicaid insurance as significant effect modifiers.
Increased WDs for advanced imaging significantly increases the likelihood of missed appointments. This effect is most pronounced among underrepresented minorities and patients with lower socioeconomic status. Efforts to reduce WDs may improve equity in access to and utilization of advanced diagnostic imaging for all patients.
本研究旨在探讨在不同人口统计学和社会经济因素下，等待天数（WDs）对门诊磁共振成像（MRI）预约失约的影响。
本研究为一项为期 12 个月的回顾性研究，对接受门诊 MRI 检查的成年患者进行了机构审查委员会批准的回顾性研究。获取了预约数据和人口统计学信息。将失约的影像学预约定义为错过了预定的影像学检查。WDs 定义为从研究医嘱到预约的天数。采用多变量逻辑回归评估种族和社会经济因素对失约的影响。采用协方差分析统计学方法，对按种族、收入和患者保险分组的失约率与 WDs 之间的关系进行了线性回归分析。
共有 42727 名患者符合纳入标准。平均 WDs 为 7.95 天。多变量回归显示，WDs 增加的患者失约的几率比增加（7-21 天：比值比 [OR]，1.39；>21 天：OR，1.77），非裔美国患者（OR，1.71），西班牙裔患者（OR，1.30），无商业保险的患者（OR，2.00-2.55），以及在主医院院区进行影像学检查的患者（OR，1.51）。失约率与 WDs 呈线性增加，协方差分析显示少数民族和医疗补助保险是显著的效应修饰因子。
高级影像学检查的 WDs 增加显著增加了失约的可能性。这种影响在代表性不足的少数族裔和社会经济地位较低的患者中最为明显。减少 WDs 的努力可能会提高所有患者获得和利用高级诊断影像学的公平性。
