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远程医疗与面对面护理模式中爽约或未就诊率的系统评价与荟萃分析。

Systematic review and meta-analysis of no show or non-attendance rates among telehealth and in-person models of care.

作者信息

Greenup Edwin Phillip, Best Daniel

机构信息

Department of Health, Clinical Excellence Queensland, Queensland Health, Level 2, 15 Butterfield Street, Herston, Brisbane, QLD, 4006, Australia.

出版信息

BMC Health Serv Res. 2025 May 9;25(1):663. doi: 10.1186/s12913-025-12826-2.

Abstract

OBJECTIVES

Comparisons of no-show rates between virtual and in-person models of care are commonly reported during evaluation, indicating how coveted improvements in attendance are to health service providers. This study seeks to synthesise the data from studies that make these comparisons, providing a more accurate indication of what may expected from the use of virtual care models for clinicians and administrators.

STUDY DESIGN

Systematic review and meta-analysis of 45 retrospective cohort studies.

METHODS

A literature review involving five databases was conducted, identifying 441 articles for screening. 45 were included for further analysis. A Random effects model was used to calculate the effect size, with further analysis conducted to determine heterogeneity and publication bias.

RESULTS

The Random effects model estimated a reduced likelihood non-attendance in patients receiving virtual care compared to in-person groups (OR = 0.61). An I indicated a high degree of heterogeneity among the studies analysed. The Fail-Safe N suggested that the results are robust and not significantly influenced by publication bias.

CONCLUSIONS

The meta-analysis indicated that on average, telehealth models of care implemented since COVID-19 provide a moderate reduction in risk of patient non-attendance when compared to in-person alternatives.

摘要

目的

在评估过程中,虚拟护理模式与面对面护理模式的失约率比较经常被报道,这表明健康服务提供者对提高就诊率的渴望程度。本研究旨在综合进行这些比较的研究数据,为临床医生和管理人员使用虚拟护理模式可能带来的预期提供更准确的指示。

研究设计

对45项回顾性队列研究进行系统评价和荟萃分析。

方法

对五个数据库进行文献综述,识别出441篇文章进行筛选。45篇文章被纳入进一步分析。使用随机效应模型计算效应量,并进行进一步分析以确定异质性和发表偏倚。

结果

随机效应模型估计,与面对面护理组相比,接受虚拟护理的患者未就诊的可能性降低(OR = 0.61)。I表明所分析的研究之间存在高度异质性。失效安全数表明结果稳健,不受发表偏倚的显著影响。

结论

荟萃分析表明,自新冠疫情以来实施的远程医疗护理模式与面对面护理模式相比,平均而言可适度降低患者未就诊的风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/dd10/12063363/924f8b3e258d/12913_2025_12826_Fig1_HTML.jpg

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