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为什么患者会在泌尿生殖科诊所失访?一项多因素分析。

Why do patients default from follow-up at a genitourinary clinic?: a multivariate analysis.

作者信息

Ross J D, McIver A, Blakely A, Dalrymple J, Peacock W, Wallis C

机构信息

Department of Genitourinary Medicine, Edinburgh Royal Infirmary.

出版信息

Genitourin Med. 1995 Dec;71(6):393-5. doi: 10.1136/sti.71.6.393.

Abstract

OBJECTIVE

Firstly to compare the proportion of patients defaulting from follow up at a genitourinary medicine clinic with those attending other hospital based clinics. Secondly to determine which factors are associated with non attendance at a city centre genitourinary medicine clinic.

METHODOLOGY

The proportion of patients who defaulted at a genitourinary medicine clinic, a general medical clinic, a general surgical clinic and a dermatology clinic during March 1995 were compared. A multivariate logistic regression analysis was performed comparing attenders and non attenders at the genitourinary medicine clinic with respect to time of appointment, diagnosis, previous contacts with clinic staff, potential domestic commitments and patient demographics in a prospective case control study.

RESULTS

The default rate at the genitourinary medicine clinic was 15% compared with 13%, 15% and 14% for medical, surgical and dermatology clinics respectively. Patients who defaulted from the genitourinary medicine clinic (167) were compared with 172 attenders and significant differences found for timing of appointments, area of residence, frequency of counselling by the health advisor and age of the patient. Other factors such as the diagnosis, whether a woman had children, sexual orientation, whether negative results had been given over the phone, source of referral, sex of patient, employment status and the weather were not found to be significantly associated with defaulting from an appointment.

CONCLUSIONS

The time of the appointment and being seen by a health advisor were the only variables identified over which the clinic has control and therefore could potentially reduce non attendance rates.

摘要

目的

首先,比较在泌尿生殖医学诊所失访患者的比例与在其他医院诊所就诊患者的比例。其次,确定哪些因素与未到市中心泌尿生殖医学诊所就诊相关。

方法

比较了1995年3月在泌尿生殖医学诊所、普通内科诊所、普通外科诊所和皮肤科诊所失访的患者比例。在一项前瞻性病例对照研究中,对泌尿生殖医学诊所的就诊者和未就诊者进行多因素逻辑回归分析,比较预约时间、诊断、以前与诊所工作人员的接触、潜在的家庭事务以及患者人口统计学特征。

结果

泌尿生殖医学诊所的失访率为15%,而内科、外科和皮肤科诊所的失访率分别为13%、15%和14%。将泌尿生殖医学诊所失访的患者(167例)与172例就诊者进行比较,发现预约时间、居住地区、健康顾问咨询频率和患者年龄存在显著差异。其他因素,如诊断、女性是否有子女、性取向、是否通过电话告知阴性结果、转诊来源、患者性别、就业状况和天气,未发现与预约失访有显著关联。

结论

预约时间和由健康顾问接诊是诊所能够控制的、唯一可识别的变量,因此有可能降低未就诊率。

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