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未到诊患者的预测因素分析:美国某学术眼科部门的小儿眼科患者。

Predictors of No-Show Status: An Analysis of Pediatric Ophthalmology Patients at an Academic Ophthalmology Department in the United States.

出版信息

J Pediatr Ophthalmol Strabismus. 2024 Nov-Dec;61(6):442-451. doi: 10.3928/01913913-20240718-02. Epub 2024 Aug 14.

Abstract

PURPOSE

To identify pediatric patient and appointment characteristics associated with no-show status at a tertiary care pediatric ophthalmology clinic within a U.S. academic ophthalmology department.

METHODS

A cross-sectional retrospective chart review was performed for all pediatric patients with a scheduled ophthalmology appointment at the Penn State Eye Center between April 1, 2022 and March 31, 2023. A multivariate logistic regression analysis assessed associations between appointment nonattendance and patient characteristics.

RESULTS

Of 8,083 scheduled visits, 1,445 (17.9%) were no-shows. Factors associated with no-show status included appointment type (new vs return odds ratio [OR]: 1.43, 95% CI: 1.26 to 1.63, < .001); lower median household income (< $41,374 vs > $68,957 OR: 1.89, 95% CI: 1.40 to 2.55, < .001; $41,374 to $68,957 vs > $68,957 OR: 1.27, 95% CI: 1.12 to 1.44, < .001); non-private insurance (self-pay vs private: OR: 5.65, 95% CI: 3.87 to 8.24, < .001, Medicaid vs private: OR: 2.17, 95% CI: 2.32 to 3.16, < .001); commute distance 10 to 30 miles vs < 5 miles (OR: 1.49, 95% CI: 1.11 to 1.99, = .008); race: unavailable vs White (OR: 2.18, 95% CI: 1.66 to 2.85, < .001), Black vs White (OR: 1.86, 95% CI:1.53 to 2.27, < .001), Other vs White (OR: 1.47, 95% CI: 1.27 to 1.70, < .001); ethnicity: Hispanic vs non-Hispanic (OR: 1.92, 95% CI: 1.62 to 2.27, < .001); and language preference: Spanish vs English (OR: 1.86, 95% CI: 1.49 to 2.32, < .001), Nepali vs English (OR: 1.60, 95% CI: 1.06 to 2.43, = .027), other vs English (OR: 1.83, 95% CI: 1.35 to 2.49, < .001). Appointment reminders (phone call, = .013); text message, < .001; other, = .013) all resulted in a greater propensity to show, but email communication alone did not ( = .674).

CONCLUSIONS

Certain patient and appointment characteristics that are linked to a higher rate of no-show status can inform targeted initiatives to improve health care outcomes, resource utilization, and clinical efficiency in the pediatric ophthalmology community. .

摘要

目的

确定与美国学术眼科部门的三级儿科眼科诊所的未就诊状态相关的儿科患者和预约特征。

方法

对 2022 年 4 月 1 日至 2023 年 3 月 31 日期间在宾夕法尼亚州立眼科中心预约眼科就诊的所有儿科患者进行了横断面回顾性图表审查。多变量逻辑回归分析评估了预约未出席与患者特征之间的关联。

结果

在 8083 次预约中,1445 次(17.9%)为未就诊。与未就诊状态相关的因素包括预约类型(新 vs 复诊比值比[OR]:1.43,95%CI:1.26 至 1.63, <.001);较低的中位数家庭收入(<$41,374 与>$68,957 OR:1.89,95%CI:1.40 至 2.55, <.001;$41,374 至>$68,957 与>$68,957 OR:1.27,95%CI:1.12 至 1.44, <.001);非私人保险(自付与私人保险:OR:5.65,95%CI:3.87 至 8.24, <.001,医疗补助与私人保险:OR:2.17,95%CI:2.32 至 3.16, <.001);通勤距离 10 至 30 英里与<5 英里(OR:1.49,95%CI:1.11 至 1.99, =.008);种族:不可用与白人(OR:2.18,95%CI:1.66 至 2.85, <.001),黑人与白人(OR:1.86,95%CI:1.53 至 2.27, <.001),其他与白人(OR:1.47,95%CI:1.27 至 1.70, <.001);族裔:西班牙裔与非西班牙裔(OR:1.92,95%CI:1.62 至 2.27, <.001);语言偏好:西班牙语与英语(OR:1.86,95%CI:1.49 至 2.32, <.001),尼泊尔语与英语(OR:1.60,95%CI:1.06 至 2.43, =.027),其他语言与英语(OR:1.83,95%CI:1.35 至 2.49, <.001)。预约提醒(电话, =.013);短信, <.001);其他, =.013)均增加了就诊的倾向,但电子邮件通知单独使用时没有这种效果( =.674)。

结论

某些与较高未就诊状态相关的患者和预约特征可以为改善儿科眼科社区的医疗保健结果、资源利用和临床效率提供信息。.

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