Centre for Online Health, The University of Queensland, Brisbane, Queensland, Australia.
Centre for Health Services Research, The University of Queensland, Brisbane, Queensland, Australia.
Telemed J E Health. 2021 Jul;27(7):733-738. doi: 10.1089/tmj.2020.0176. Epub 2020 Aug 19.
Videoconference enables outpatient appointments to be conducted in a manner that increases convenience for patients, and this increase in convenience is widely assumed to reduce failure to attend (FTA) rates. FTA is the notation used when patients do not attend their designated outpatient appointment. FTA events waste appointment resources that could have been allocated to another patient and increase clinic waiting lists. Therefore, predicting FTA or identifying mechanisms to improve FTA rates could have both economic and patient benefits. Using activity data and patient demographic information from the immunology outpatient services at a large metropolitan hospital in Australia, descriptive statistics and regression analysis were used to investigate whether the telehealth modality or other patient or clinic characteristics had the potential to influence FTA rates. Multivariate logistic regression analysis was conducted using a panel set to group individual patient events together to explore the ability of patient characteristics or appointment characteristics to predict FTA events. Ethics approval was received from the Metro South Health Human Research Ethics Committee (HREC/18/QMS/45889). From April 2016 to September 2018, 6,131 appointments occurred, with an overall FTA rate of 16%. Telehealth accounted for 254 or 4.1% of all appointments. When in-person and telehealth modalities were examined separately, the FTA rates were 16.3% and 8.7%, respectively. The greatest predictor of FTA was found to be the modality by which the clinic was delivered, in person or telehealth. Patient-specific characteristics such as Indigenous status, previous FTA behavior, and whether the person was privately funded were also important factors. These results indicate that offering appropriate patients the option of telehealth has the potential to reduce FTA. Given the impact of FTA on clinic viability, caseload burden, and waiting lists, telehealth should be explored further and, where possible, should be offered as a routine alternative to in-person appointments.
视频会议使门诊预约更加方便患者，人们普遍认为这种便利性的提高会降低失约率（FTA）。FTA 是指患者未参加指定的门诊预约时使用的标记。FTA 事件浪费了本来可以分配给其他患者的预约资源，并增加了诊所的候诊名单。因此，预测 FTA 或确定提高 FTA 率的机制可能既具有经济效益又有益于患者。
利用澳大利亚一家大型都市医院的免疫门诊服务的活动数据和患者人口统计学信息，采用描述性统计和回归分析来调查远程医疗模式或其他患者或诊所特征是否有可能影响 FTA 率。使用面板集对个体患者事件进行分组的多变量逻辑回归分析，探讨患者特征或预约特征是否有能力预测 FTA 事件。这项研究已获得 Metro South 卫生人体研究伦理委员会（HREC/18/QMS/45889）的伦理批准。
2016 年 4 月至 2018 年 9 月，共进行了 6131 次预约，整体失约率为 16%。远程医疗占所有预约的 254 次或 4.1%。分别检查面对面和远程医疗模式时，失约率分别为 16.3%和 8.7%。结果发现，导致失约的最大因素是提供诊所服务的方式，即面对面或远程医疗。患者的具体特征，如土著身份、以往的失约行为以及患者是否自费，也是重要因素。
这些结果表明，为合适的患者提供远程医疗选择有可能降低失约率。鉴于失约对诊所的生存能力、工作量负担和候诊名单的影响，应进一步探索远程医疗，并在可能的情况下，将其作为面对面预约的常规替代方案提供。
