海地社会政治危机背景下患者提醒系统的实施：结果评估。

Implementation of a patient reminder system in Haiti in a socio-political crisis context: evaluation of outcomes.

机构信息

Association de Technologistes Médicaux Licenciés d'Haiti (ATMLH), Port-au-Prince, Haiti.

Hopital Sage Citymed, Port-au-Prince, Haiti.

出版信息

BMC Health Serv Res. 2024 Aug 20;24(1):958. doi: 10.1186/s12913-024-11395-0.

DOI:10.1186/s12913-024-11395-0

PMID:39164639

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11337644/

Abstract

BACKGROUND

In Haiti, patient's adherence to treatment and compliance with medical appointments are very challenging due to different local factors. We aimed to assess the effectiveness of a reminder system implemented in health facilities in Haiti in a context of socio-political crisis.

METHODS

We used appointment data from patients aged 15 years and older between January 2021 and November 2023 from four healthcare centers in the Port-au-Prince metropolitan area. We performed descriptive analysis, crossing covariates with appointment attendance. We performed Pearson's Chi-squared test, and multivariate regression analysis using a mixed-effect logistic regression model in order to explore the association between sending reminders and appointment attendance, with and without adjustment for other patient-level covariates.

RESULTS

A total of 14 108 appointments were registered on the reminder systems, with 2 479 (17.6%) attendances. Among those to whom reminders were sent, the number of attendances was 167 (17.4%) for email recipients only, 199 (36.7%) for SMS recipients only, and 19 (42.2%) for both SMS and email recipients - versus 2 094 (16.7%) for non-reminders. After adjusting on all other covariates, we found that patients to whom a reminder was sent via email (aOR: 1.45; CI: 1.08, 1.94), SMS (aOR: 2.95; CI: 2.41, 3.60), and both SMS and email (aOR: 2.86, CI: 1.37, 5.96) were more likely to show up on their appointment day compared to those who did not receive any reminder. Other socio-demographic factors such as being 50 years and older (aOR: 1.31; CI: 1.10, 1.56) compared to under 30 years, living as couple (aOR: 1.23; CI: 1.10, 1.37), and not having children (aOR: 1.21; CI: 1.07, 1.37) were significantly associated with appointment attendance.

CONCLUSIONS

Our study suggests that patient reminder systems may be used to reduce non-attendance in Haiti, even in a context of socio-political crisis.

摘要

背景

在海地，由于当地的各种因素，患者对治疗的依从性和对医疗预约的遵守情况极具挑战性。我们旨在评估在社会政治危机背景下，海地卫生机构实施的提醒系统的有效性。

方法

我们使用了 2021 年 1 月至 2023 年 11 月来自太子港大都市区的四家医疗中心年龄在 15 岁及以上患者的预约数据。我们进行了描述性分析，将协变量与预约出席情况进行了交叉对照。我们进行了 Pearson 卡方检验和多变量回归分析，采用混合效应逻辑回归模型，以探索发送提醒与预约出席之间的关联，同时对其他患者水平的协变量进行了调整和未调整。

结果

在提醒系统上共登记了 14108 次预约，其中有 2479 次（17.6%）出席。在收到提醒的人中，仅收到电子邮件的有 167 次（17.4%），仅收到短信的有 199 次（36.7%），同时收到短信和电子邮件的有 19 次（42.2%），而未收到提醒的有 2094 次（16.7%）。在调整了所有其他协变量后，我们发现收到电子邮件提醒的患者（比值比（OR）：1.45；置信区间（CI）：1.08，1.94）、短信提醒（OR：2.95；CI：2.41，3.60）和同时收到短信和电子邮件提醒（OR：2.86，CI：1.37，5.96）的患者在预约当天出现的可能性要大于未收到任何提醒的患者。其他社会人口学因素，如 50 岁及以上（OR：1.31；CI：1.10，1.56）与 30 岁以下、夫妻同住（OR：1.23；CI：1.10，1.37）和没有孩子（OR：1.21；CI：1.07，1.37）与预约出席情况显著相关。