Universidade Federal do Rio Grande do Sul, Porto Alegre, Rio Grande do Sul, Brazil.
Universidade Federal de Mato Grosso, Varzea Grande, Mato Grosso, Brazil.
Int J Health Plann Manage. 2022 Sep;37(5):2889-2904. doi: 10.1002/hpm.3527. Epub 2022 Jun 1.
Patients' no-shows negatively impact healthcare systems, leading to resources' underutilisation, efficiency loss, and cost increase. Predicting no-shows is key to developing strategies that counteract their effects. In this paper, we propose a model to predict the no-show of ambulatory patients to exam appointments of computed tomography at the Radiology department of a large Brazilian public hospital.
We carried out a retrospective study on 8382 appointments to computed tomography (CT) exams between January and December 2017. Penalised logistic regression and multivariate logistic regression were used to model the influence of 15 candidate variables on patients' no-shows. The predictive capabilities of the models were evaluated by analysing the Area Under the Curve (AUC) of the Receiver Operating Characteristic (ROC).
The no-show rate in computerised tomography exams appointments was 6.65%. The two models performed similarly in terms of AUC. The penalised logistic regression model was selected using the parsimony criterion, with 8 of the 15 variables analysed appearing as significant. One of the variables included in the model (number of exams scheduled in the previous year) had not been previously reported in the related literature.
Our findings may be used to guide the development of strategies to reduce the no-show of patients to exam appointments.
患者失约会对医疗系统产生负面影响,导致资源利用不足、效率降低和成本增加。预测失约情况是制定应对其影响策略的关键。本文提出了一种预测放射科门诊患者计算机断层扫描(CT)检查预约失约的模型。
我们对 2017 年 1 月至 12 月期间 8382 次 CT 检查预约进行了回顾性研究。使用惩罚逻辑回归和多变量逻辑回归分析了 15 个候选变量对患者失约的影响,通过分析受试者工作特征曲线(ROC)下的面积(AUC)评估模型的预测能力。
CT 检查预约的失约率为 6.65%。两个模型在 AUC 方面表现相似。基于简约标准选择了惩罚逻辑回归模型,分析的 15 个变量中有 8 个变量具有统计学意义。模型中包含的一个变量(前一年安排的检查次数)在相关文献中尚未报道过。
我们的研究结果可以用来指导制定减少患者检查预约失约的策略。