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评价一家三级医院的患者失约情况:重点关注预约方式和预约类型。

Evaluation of Patient No-Shows in a Tertiary Hospital: Focusing on Modes of Appointment-Making and Type of Appointment.

机构信息

Severance Children's Hospital, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.

Department of Public Health, Yonsei University, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea.

出版信息

Int J Environ Res Public Health. 2021 Mar 22;18(6):3288. doi: 10.3390/ijerph18063288.

Abstract

No-show appointments waste resources and decrease the sustainability of care. This study is an attempt to evaluate patient no-shows based on modes of appointment-making and types of appointments. We collected hospital information system data and appointment data including characteristics of patients, service providers, and clinical visits over a three-month period (1 September 2018 to 30 November 2018), at a large tertiary hospital in Seoul, Korea. We used multivariate logistic regression analyses to identify the factors associated with no-shows (Model 1). We further assessed no-shows by including the interaction term ("modes of appointment-making" X "type of appointment") (Model 2). Among 1,252,127 appointments, the no-show rate was 6.12%. Among the modes of appointment-making, follow-up and online/telephone appointment were associated with higher odds of no-show compared to walk-in. Appointments for treatment and surgery had higher odds ratios of no-show compared to consultations. Tests for the interaction between the modes of appointment-making and type of appointment showed that follow-up for examination and online/telephone appointments for treatment and surgery had much higher odds ratios of no-shows. Other significant factors of no-shows include age, type of insurance, time of visit, lead time (time between scheduling and the appointment), type of visits, doctor's position, and major diagnosis. Our results suggest that future approaches for predicting and addressing no-show should also consider and analyze the impact of modes of appointment-making and type of appointment on the model of prediction.

摘要

失约预约浪费资源,降低医疗服务的可持续性。本研究旨在评估基于预约方式和预约类型的患者失约情况。我们收集了韩国首尔一家大型三级医院在三个月期间(2018 年 9 月 1 日至 11 月 30 日)的医院信息系统数据和预约数据,包括患者、服务提供者和临床就诊的特征。我们使用多变量逻辑回归分析来确定与失约相关的因素(模型 1)。我们通过纳入交互项(“预约方式”X“预约类型”)(模型 2)进一步评估失约情况。在 1,252,127 次预约中,失约率为 6.12%。在预约方式中,与现场预约相比,随访和在线/电话预约的失约可能性更高。治疗和手术预约的失约可能性高于咨询预约。预约方式和预约类型之间交互作用的检验表明,检查随访和治疗及手术的在线/电话预约的失约可能性更高。其他显著的失约因素包括年龄、保险类型、就诊时间、预约提前期(预约安排和预约之间的时间)、就诊类型、医生职位和主要诊断。我们的研究结果表明,未来预测和解决失约问题的方法还应考虑和分析预约方式和预约类型对预测模型的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fb16/8005203/16b434d368f7/ijerph-18-03288-g001.jpg

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