White Randie, Cangero Theodore, Feustel Paul J, Kogan Barry A
Maine Medical Center, Portland, Maine.
Albany Medical Center, Albany, New York.
Urol Pract. 2021 Jul;8(4):480-486. doi: 10.1097/UPJ.0000000000000225. Epub 2021 Apr 15.
We sought to examine why patients miss appointments in a large academic urology practice.
We conducted a retrospective analysis of 83,983 patient appointments in our faculty urology group between May 1, 2017 and December 1, 2020. Appointment data from 17 providers were included. Data were collected on diagnosis, age, gender, insurance type, nonattendance history, lead time between scheduling and appointment, clinic location and outpatient procedures vs general office visit or telehealth visit.
A total of 7,592 (9.0%) appointments were missed. Patients seen for oncologic diagnosis had the lowest missed appointment rate (4.5%), as compared with benign urology (9.6%) and pediatrics (13.0%). Previous nonattendance history within the last year was associated with nonattendance again (OR 2.47, 95% CI 2.29-2.66). Patients with Medicaid had the highest rate of missed appointments (17.2%; OR 2.16, 95% CI 2.02-2.32). Increased lead time between appointments increased the odds of nonattendance (OR 1.018/week, CI 1.016-1.020). Patients undergoing procedures had the lowest nonattendance rate (3.4%), compared with both new (11.4%) and followup (10.5%) visits, while both telephone (2.9%; OR 0.41, 95% CI 0.32-0.53) and video (2.8%; OR 0.37, 95% CI 0.20-0.71) visits had lower rates of nonattendance when compared to in-person visits.
We found a nonattendance rate of 9% in our practice. Those patients with oncologic diagnoses and those having procedures or telemedicine visits had the lowest rates. Those who have missed an appointment in the past are at the highest risk nonattendance and should be targeted to improve patient health as well as practice efficiency.
我们试图探究在一家大型学术性泌尿外科诊所中患者错过预约的原因。
我们对2017年5月1日至2020年12月1日期间我们科室泌尿外科团队的83983次患者预约进行了回顾性分析。纳入了17名医护人员的预约数据。收集了关于诊断、年龄、性别、保险类型、未就诊历史、预约安排与就诊之间的提前时间、诊所位置以及门诊手术与普通门诊就诊或远程医疗就诊的数据。
总共7592次（9.0%）预约被错过。接受肿瘤诊断的患者错过预约率最低（4.5%），相比之下，良性泌尿外科疾病患者为（9.6%），儿科患者为（13.0%）。过去一年中的未就诊历史与再次未就诊相关（比值比2.47，95%置信区间2.29 - 2.66）。医疗补助患者错过预约率最高（17.2%；比值比2.16，95%置信区间2.02 - 2.32）。预约之间提前时间增加会增加未就诊几率（每周比值比1.018，置信区间1.016 - 1.020）。接受手术的患者未就诊率最低（3.4%），相比新就诊患者（11.4%）和随访患者（10.5%）而言，而电话就诊（2.9%；比值比0.41，95%置信区间0.32 - 0.53）和视频就诊（2.8%；比值比0.37，95%置信区间0.20 - 0.71）与面对面就诊相比未就诊率更低。
我们发现在我们的诊所中未就诊率为9%。那些接受肿瘤诊断的患者以及接受手术或进行远程医疗就诊的患者未就诊率最低。那些过去错过预约的患者未就诊风险最高，应针对他们来改善患者健康状况以及诊所效率。
