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监禁情况和急诊科就诊频率作为县医院白内障手术缺诊日的预测因素。

Incarceration and emergency department visit frequency as predictors for missing day of cataract surgery at County hospital.

作者信息

Wurster Patrick, Tharp Margaret, Ho Kathleen, Eikenberry Jennifer

机构信息

Eugene and Marilyn Glick Eye Institute, Indianapolis, IN, USA.

Department of Ophthalmology, Indiana University School of Medicine, Indianapolis, IN, USA.

出版信息

J Med Access. 2025 Jul 24;9:27550834251359809. doi: 10.1177/27550834251359809. eCollection 2025 Jan-Dec.

Abstract

BACKGROUND

Understanding the factors associated with patient no-shows is essential for healthcare providers to develop strategies to optimize patient care, as these can delay care and increase cost. This retrospective study aimed to identify factors associated with higher likelihood of patients missing their scheduled cataract surgery appointments at a county hospital.

METHODS

A retrospective chart review was performed using data collected from the surgery schedule and electronic medical record on patients aged 18-100 years scheduled for cataract surgery at Eskenazi Hospital between January 1, 2022, and December 31, 2022. Logistic regression was used to compare factors of age, race, ethnicity, primary spoken and written language, insurance status, best-corrected visual acuity and number of admissions to the emergency department of the same hospital in the preceding year to attendance of cataract surgery on scheduled date.

RESULTS

This study found that in the studied population (n = 242), being incarcerated was a statistically significant predictor of missing the scheduled cataract surgery appointment (OR 6.14, 95% CI 1.14-33.16, p = 0.035). In addition, having at least one emergency department visit in the prior year (OR 6.50, CI 1.83-23.1, p = 0.004) was found to be significant, with a greater difference in patients who had at least three emergency department visits in the prior year (OR 13.2, CI 3.21-52.6, p < 0.001). Other studied factors were not found to be statistically significant predictors of missing the surgery appointment, although having best-corrected vision of count fingers or worse neared statistical significance of predicting missing cataract surgery appointment. These findings may potentially direct targeted intervention strategies to improve access to cataract care.

摘要

背景

了解与患者爽约相关的因素对于医疗服务提供者制定优化患者护理的策略至关重要,因为这些因素可能会延误治疗并增加成本。这项回顾性研究旨在确定在一家县医院中,与患者错过预定白内障手术预约可能性较高相关的因素。

方法

使用从2022年1月1日至2022年12月31日在埃斯凯纳齐医院计划进行白内障手术的18至100岁患者的手术时间表和电子病历中收集的数据进行回顾性病历审查。采用逻辑回归比较年龄、种族、民族、主要口语和书面语言、保险状况、最佳矫正视力以及上一年在同一家医院急诊科的就诊次数等因素与按预定日期进行白内障手术的出勤率。

结果

本研究发现,在所研究的人群(n = 242)中,被监禁是错过预定白内障手术预约的统计学显著预测因素(比值比6.14,95%置信区间1.14 - 33.16,p = 0.035)。此外,发现上一年至少有一次急诊科就诊(比值比6.50,置信区间1.83 - 23.1,p = 0.004)具有显著性,上一年至少有三次急诊科就诊的患者差异更大(比值比13.2,置信区间3.21 - 52.6,p < 0.001)。其他研究因素未被发现是错过手术预约的统计学显著预测因素,尽管最佳矫正视力为指数或更差接近预测错过白内障手术预约的统计学显著性。这些发现可能会指导有针对性的干预策略,以改善白内障护理的可及性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b315/12290347/eafc17af09c5/10.1177_27550834251359809-fig1.jpg

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