School of Management, University of Bath, Bath, United Kingdom.
Department of Psychological and Behavioural Science, London School of Economics and Political Science, London, United Kingdom.
PLoS One. 2022 Sep 29;17(9):e0274670. doi: 10.1371/journal.pone.0274670. eCollection 2022.
The burden of missed healthcare appointments is so great that even small reductions in Did Not Attend (DNA) rate can secure tangible benefits. Previous studies have identified demographic factors that predict DNA rate. However, it is not obvious that these insights can be used to improve attendance, as healthcare providers do not control patient demographics. One factor that providers do control is appointment scheduling. We previously reported that appointments at the beginning of the week are more likely to be missed than appointments at the end of the week. This observation suggests a simple intervention to reduce DNA rate: schedule appointments for later in the week. Using data from a UK mental health hospital, we compared attendance rates for 12-months before and 12-months after the intervention began (916 appointments in total). Overall DNA rate fell from 34.2% pre-intervention to 23.4% post-intervention [χ2 (1, N = 916) = 13.01, p < 0.001; Relative Risk Reduction, 31.6%]. This effect was carried mainly by female patients, for whom more appointments could be moved to later in the week. Our findings confirm that DNA rate can be significantly reduced by loading appointments onto high-attendance days.
错过医疗保健预约的负担非常大，即使就诊未到率（Did Not Attend，DNA）略有降低，也能带来切实的收益。先前的研究已经确定了预测 DNA 率的人口统计学因素。然而，由于医疗保健提供者无法控制患者的人口统计学特征，这些发现是否能用于提高就诊率并不明显。提供者可以控制的一个因素是预约安排。我们之前曾报告过，与周末的预约相比，一周开始时的预约更有可能被错过。这一观察结果表明，有一种简单的干预措施可以降低 DNA 率：将预约安排在一周的晚些时候。我们使用来自英国一家精神健康医院的数据，比较了干预开始前 12 个月和开始后 12 个月的就诊率（总共 916 次预约）。总体 DNA 率从干预前的 34.2%降至干预后的 23.4%[χ2（1，N=916）=13.01，p<0.001；相对风险降低，31.6%]。这一效果主要是由女性患者带来的，因为她们的更多预约可以安排在一周的晚些时候。我们的研究结果证实，通过将预约安排在高就诊日，可以显著降低 DNA 率。
