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谁会出现?预测美国常规 HIV 初级保健中患者的失约情况。

Who Will Show? Predicting Missed Visits Among Patients in Routine HIV Primary Care in the United States.

机构信息

Department of Epidemiology, Gillings School of Global Public Health, The University of North Carolina at Chapel Hill, 2101 McGavran-Greenberg Hall, Chapel Hill, NC, 27599, USA.

Department of Epidemiology, Brown University, Providence, RI, USA.

出版信息

AIDS Behav. 2019 Feb;23(2):418-426. doi: 10.1007/s10461-018-2215-1.


DOI:10.1007/s10461-018-2215-1
PMID:30006790
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6330260/
Abstract

Missed HIV medical visits predict poor clinical outcomes. We sought to identify patients at high risk of missing visits. We analyzed 2002-2014 data from six large US HIV clinics. At each visit, we predicted the likelihood of missing the next scheduled visit using demographic, clinical, and patient-reported psychosocial variables. Overall, 10,374 participants contributed 105,628 HIV visits. For 17% of visits, the next scheduled appointment was missed. The strongest predictor of a future missed visit was past-year missed visits. A model with only this predictor had area under the receiver operator curve = 0.65; defining "high risk" as those with any past-year missed visits had 73% sensitivity and 51% specificity in correctly identifying a future missed visit. Inclusion of other clinical and psychosocial predictors only slightly improved performance. Past visit attendance can identify those at increased risk for future missed visits, allowing for proactive allocation of resources to those at greatest risk.

摘要

错过艾滋病病毒医疗随访会导致不良临床结局。我们试图确定高风险的失访患者。我们分析了来自 6 家美国大型艾滋病病毒诊所的 2002-2014 年数据。在每次就诊时,我们使用人口统计学、临床和患者报告的心理社会变量预测下一次预约就诊的可能性。总体而言,10374 名参与者贡献了 105628 次艾滋病病毒就诊。17%的就诊预约被错过。未来错过就诊的最强预测因素是过去一年的就诊失约。仅包含此预测因素的模型,其受试者工作特征曲线下面积为 0.65;将过去一年有任何失约就诊记录的患者定义为“高风险”,则在正确识别未来失约就诊方面的敏感性为 73%,特异性为 51%。纳入其他临床和心理社会预测因素仅略微提高了性能。过去的就诊出勤率可以识别出未来失访风险较高的患者,从而可以为风险最高的患者主动分配资源。

相似文献

[1]
Who Will Show? Predicting Missed Visits Among Patients in Routine HIV Primary Care in the United States.

AIDS Behav. 2019-2

[2]
Predicting Retention in HIV Primary Care: Is There a Missed Visits Continuum Based on Patient Characteristics?

AIDS Behav. 2019-9

[3]
Missed Initial Medical Visits: Predictors, Timing, and Implications for Retention in HIV Care.

AIDS Patient Care STDS. 2017-5

[4]
Missed office visits and risk of mortality among HIV-infected subjects in a large healthcare system in the United States.

AIDS Patient Care STDS. 2013-7-19

[5]
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HIV Clin Trials. 2012

[6]
Regular clinic attendance in two large San Francisco HIV primary care settings.

AIDS Care. 2016

[7]
Retention strategies and factors associated with missed visits among low income women at increased risk of HIV acquisition in the US (HPTN 064).

AIDS Patient Care STDS. 2014-4

[8]
Factors Associated with Missed Psychiatry Visits in an Urban HIV Clinic.

AIDS Behav. 2015-8

[9]
Association of Increased Chronicity of Depression With HIV Appointment Attendance, Treatment Failure, and Mortality Among HIV-Infected Adults in the United States.

JAMA Psychiatry. 2018-4-1

[10]
Where is the patient? The association of psychosocial factors and missed primary care appointments in patients with diabetes.

Gen Hosp Psychiatry. 2006

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BMC Glob Public Health. 2025-7-24

[2]
Development and Validation of a Novel Risk Calculator to Predict Sub-optimal HIV Outcomes Among Pregnant and Postpartum Women with HIV in Kenya.

AIDS Behav. 2025-7-10

[3]
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JMIR Res Protoc. 2025-5-22

[4]
Development of a machine learning prediction model for loss to follow-up in HIV care using routine electronic medical records in a low-resource setting.

BMC Med Inform Decis Mak. 2025-5-19

[5]
The heterogeneity among people re-engaging in antiretroviral therapy highlights the need for a differentiated approach: results from a cross-sectional study in Johannesburg, South Africa.

J Int AIDS Soc. 2024-12

[6]
Rate and predictors of loss to follow-up in HIV care in a low-resource setting: analyzing critical risk periods.

BMC Infect Dis. 2024-10-18

[7]
Prevention of adverse HIV treatment outcomes: machine learning to enable proactive support of people at risk of HIV care disengagement in Tanzania.

BMJ Open. 2024-9-24

[8]
Provocative Findings From a Transdiagnostic Counseling Intervention to Improve Psychiatric Comorbidity and HIV Care Engagement Among People With HIV: A Pilot Randomized Clinical Trial.

J Acquir Immune Defic Syndr. 2024-9-1

[9]
Demographic and Clinical Characteristics Predicting Missed Clinic Visits among Patients Living with HIV on Antiretroviral Treatment in Kinshasa and Haut-Katanga Provinces of the Democratic Republic of Congo.

Healthcare (Basel). 2024-7-3

[10]
Exploring the Feasibility of an Electronic Tool for Predicting Retention in HIV Care: Provider Perspectives.

Int J Environ Res Public Health. 2024-5-24

本文引用的文献

[1]
Missed Initial Medical Visits: Predictors, Timing, and Implications for Retention in HIV Care.

AIDS Patient Care STDS. 2017-5

[2]
Human immunodeficiency virus transmission at each step of the care continuum in the United States.

JAMA Intern Med. 2015-4

[3]
Vital Signs: HIV diagnosis, care, and treatment among persons living with HIV--United States, 2011.

MMWR Morb Mortal Wkly Rep. 2014-11-28

[4]
Beyond core indicators of retention in HIV care: missed clinic visits are independently associated with all-cause mortality.

Clin Infect Dis. 2014-11-15

[5]
Enhanced personal contact with HIV patients improves retention in primary care: a randomized trial in 6 US HIV clinics.

Clin Infect Dis. 2014-9-1

[6]
The state of engagement in HIV care in the United States: from cascade to continuum to control.

Clin Infect Dis. 2013-6-23

[7]
Measuring retention in HIV care: the elusive gold standard.

J Acquir Immune Defic Syndr. 2012-12-15

[8]
A low-effort, clinic-wide intervention improves attendance for HIV primary care.

Clin Infect Dis. 2012-7-24

[9]
Establishment, retention, and loss to follow-up in outpatient HIV care.

J Acquir Immune Defic Syndr. 2012-7-1

[10]
Guidelines for improving entry into and retention in care and antiretroviral adherence for persons with HIV: evidence-based recommendations from an International Association of Physicians in AIDS Care panel.

Ann Intern Med. 2012-3-5

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