Ibach M B
Louisiana State University Medical Center, Shreveport, Section of Gastroenterology and Hepatology, USA.
J La State Med Soc. 1995 Jul;147(7):321-4.
To determine compliance with outpatient evaluation after hospitalization and identify factors that predict postdischarge noncompliance, the charts of 449 patients discharged from the medical service of a university hospital during a 1-month period were reviewed. Those with studies scheduled following discharge were identified and compliance rates determined based on type of study, age, sex, race, and financial classification. Results were subjected to chi-square analysis using 95% confidence intervals. Of the 449 charts reviewed, 48 patients (10.7%) were identified with 59 outpatient studies scheduled. Thirty-one (64.6%) patients underwent their evaluations as scheduled. Thirty-eight (64.4%) of the scheduled studies were completed. Lower compliance rates were found in patients younger than 40, females, blacks, and Medicaid patients, but none of the differences reached statistical significance. As economic pressure continues to move health care to the outpatient setting, patient compliance is becoming an increasingly important factor in the delivery of cost-effective health care. Therefore, identifying accurate predictors of compliance is equally important. Based on the findings of this study, age, sex, race, and financial classification cannot be used as accurate predictors of compliance.
为了确定患者住院后门诊评估的依从性，并找出预测出院后不依从的因素，我们回顾了一所大学医院内科在1个月内出院的449例患者的病历。确定那些出院后安排了检查的患者，并根据检查类型、年龄、性别、种族和财务分类确定依从率。结果采用卡方分析，置信区间为95%。在审查的449份病历中，48例患者（10.7%）被确定安排了59项门诊检查。31例（64.6%）患者按计划进行了评估。38项（64.4%）计划检查得以完成。年龄小于40岁的患者、女性、黑人及医疗补助患者的依从率较低，但这些差异均未达到统计学意义。随着经济压力促使医疗保健越来越多地转向门诊治疗，患者依从性正成为提供具有成本效益的医疗保健服务中一个日益重要的因素。因此，确定准确的依从性预测指标同样重要。根据本研究结果，年龄、性别、种族和财务分类不能用作依从性的准确预测指标。
