Smith C M, Yawn B P
Family Medical Center, Hennepin County Medical Center, Minneapolis, Minnesota.
J Fam Pract. 1994 Jan;38(1):25-9.
Failure to keep an appointment not only affects the patient's health care, but also has an impact on the effectiveness and productivity of the medical facility. This study explored patient demographic factors associated with appointment keeping.
In a Midwestern, urban family practice residency clinic serving 2500 patient visits each month, data were obtained from the computer scheduling system and chart audits for 4669 patients who kept or missed 7283 physician appointments between April and June 1991. Independent variables studied were age, race and ethnicity, type of health insurance, marital status, sex, patient status, day and time of appointment, medical reason for the visit, and geographic proximity to the clinic.
The kept-appointment rate for this study was 73.9%. Appointment keeping was associated with age, race and ethnicity, type of health insurance, the day of the appointment, the medical reason for the visit, and geographic proximity to the clinic. Rates of appointment keeping were higher for patients who were older, who were Asian or white, who had private or managed care insurance, who had longer distances to travel to the clinic, and those who had appointments scheduled for the day on which they contacted the clinic.
Several identifiable factors significantly affect whether a patient will keep a clinic appointment. Our findings should be considered in program changes in appointment scheduling and follow-up methods for noncompliant patients.
未能如约就诊不仅会影响患者的医疗保健,还会对医疗机构的效率和生产力产生影响。本研究探讨了与如约就诊相关的患者人口统计学因素。
在一家位于中西部城市的家庭医学住院医师诊所,该诊所每月接待2500人次患者就诊,从计算机排班系统和病历审核中获取了1991年4月至6月期间4669名患者的7283次医师预约就诊数据,这些患者有如约就诊或失约情况。所研究的自变量包括年龄、种族和族裔、医疗保险类型、婚姻状况、性别、患者状态、预约日期和时间、就诊的医学原因以及与诊所的地理距离。
本研究的如约就诊率为73.9%。如约就诊与年龄、种族和族裔、医疗保险类型、预约日期、就诊的医学原因以及与诊所的地理距离有关。年龄较大的患者、亚裔或白人患者、拥有私人保险或管理式医疗保险的患者、前往诊所路程较远的患者以及预约在联系诊所当天就诊的患者,如约就诊率更高。
几个可识别的因素会显著影响患者是否会如约就诊。在针对未如约就诊患者的预约安排和随访方法的项目变更中,应考虑我们的研究结果。