Depression and literacy are important factors for missed appointments
Depression and literacy are important factors for missed appointments
复制标题
DOI：
10.1080/13548506.2015.1120329
复制
发表时间：
2016-01-01
影响因子：
3.8
通讯作者：
Willens, David E.
中科院分区：
文献类型：
--
作者：
Miller-Matero, Lisa Renee;Clark, Kalin Burkhardt;Willens, David E.
多个变量与错过诊所预约有关。然而，失约的发生率仍然很高，这表明其他因素可能起作用。本研究的目的是调查错过预约和多个变量之间的关系，同时在整个医疗保健系统，包括病人的人口统计学，精神症状，认知功能和识字状况。对147名连续患者进行了图表审查，这些患者在6个月内由初级保健心理学家进行了检查，并完成了确定抑郁，焦虑，睡眠，认知功能和健康素养水平的措施。人口统计信息和失约率也从图表中收集。平均失约率为15.38%。在单变量分析中，与较高失约率相关的因素包括年龄较小（p=.03）、收入较低（p =.05）、可能的抑郁症（p=.05）、睡眠困难（p=.05）和阅读能力有限（p=.003）。有趋势表明，黑人（p= 0.06）、政府保险（p= 0.06）和数学能力有限（p= 0.06）的患者错过预约的比例更高。在多变量模型中，可能的抑郁（p= 0.02）和有限的阅读能力（p= 0.003）是唯一的独立预测因素。抑郁和识字状况可能是与错过预约相关的最重要因素。影响进行了讨论，包括定期筛查抑郁症和识字状况，以及干预措施，可以用来帮助提高错过预约率。
Multiple variables are related to missed clinic appointments. However, the prevalence of missed appointments is still high suggesting other factors may play a role. The purpose of this study was to investigate the relationship between missed appointments and multiple variables simultaneously across a health care system, including patient demographics, psychiatric symptoms, cognitive functioning and literacy status. Chart reviews were conducted on 147 consecutive patients who were seen by a primary care psychologist over a six month period and completed measures to determine levels of depression, anxiety, sleep, cognitive functioning and health literacy. Demographic information and rates of missed appointments were also collected from charts. The average rate of missed appointments was 15.38%. In univariate analyses, factors related to higher rates of missed appointments included younger age (p=.03), lower income (p=.05), probable depression (p=.05), sleep difficulty (p=.05) and limited reading ability (p=.003). There were trends for a higher rate of missed appointments for patients identifying as black (p=.06), government insurance (p=.06) and limited math ability (p=.06). In a multivariate model, probable depression (p=.02) and limited reading ability (p=.003) were the only independent predictors. Depression and literacy status may be the most important factors associated with missed appointments. Implications are discussed including regular screening for depression and literacy status as well as interventions that can be utilized to help improve the rate of missed appointments.