Does the Choice Between a Telehealth and an In-Person Appointment Change Patient Attendance?
Does the Choice Between a Telehealth and an In-Person Appointment Change Patient Attendance?
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DOI：
10.1089/tmj.2020.0176
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发表时间：
2020-08-19
影响因子：
4.7
通讯作者：
Comans, Tracy A.
中科院分区：
文献类型：
--
作者：
Snoswell, Centaine L.;Comans, Tracy A.
背景：视频会议使门诊预约能够以一种增加患者便利性的方式进行，这种便利性的增加被广泛认为可以降低未能出席（FTA）率。简介：FTA是当患者不参加指定的门诊预约时使用的符号。FTA事件浪费了本可以分配给另一名患者的预约资源，并增加了诊所等候名单。因此，预测FTA或确定提高FTA率的机制可能具有经济和患者益处。材料和方法：使用活动数据和患者的人口统计信息，在澳大利亚的一个大都市医院的免疫门诊服务，描述性统计和回归分析，以调查是否远程医疗方式或其他患者或诊所的特点有可能影响FTA率。使用一组将个体患者事件分组在一起的面板组进行多变量逻辑回归分析，以探索患者特征或预约特征预测FTA事件的能力。从Metro South Health人类研究伦理委员会获得伦理批准（HREC/18/QMS/45889）。结果：从2016年4月到2018年9月，发生了6，131次预约，总体FTA率为16%。远程保健占所有预约的254人或4.1%。当分别检查面对面和远程医疗模式时，FTA率分别为16.3%和8.7%。FTA的最大预测因素被认为是提供诊所的方式，亲自或远程医疗。患者的具体特征，如原住民身份，以前的FTA行为，以及该人是否是私人资助的也是重要因素。讨论和结论：这些结果表明，为适当的患者提供远程医疗的选择有可能减少FTA。鉴于FTA对诊所生存能力、病例负担和等候名单的影响，应进一步探索远程保健，并在可能的情况下，应将其作为面对面预约的常规替代方案。
Background:Videoconference enables outpatient appointments to be conducted in a manner that increases convenience for patients, and this increase in convenience is widely assumed to reduce failure to attend (FTA) rates. Introduction:FTA is the notation used when patients do not attend their designated outpatient appointment. FTA events waste appointment resources that could have been allocated to another patient and increase clinic waiting lists. Therefore, predicting FTA or identifying mechanisms to improve FTA rates could have both economic and patient benefits. Materials and Methods:Using activity data and patient demographic information from the immunology outpatient services at a large metropolitan hospital in Australia, descriptive statistics and regression analysis were used to investigate whether the telehealth modality or other patient or clinic characteristics had the potential to influence FTA rates. Multivariate logistic regression analysis was conducted using a panel set to group individual patient events together to explore the ability of patient characteristics or appointment characteristics to predict FTA events. Ethics approval was received from the Metro South Health Human Research Ethics Committee (HREC/18/QMS/45889). Results:From April 2016 to September 2018, 6,131 appointments occurred, with an overall FTA rate of 16%. Telehealth accounted for 254 or 4.1% of all appointments. When in-person and telehealth modalities were examined separately, the FTA rates were 16.3% and 8.7%, respectively. The greatest predictor of FTA was found to be the modality by which the clinic was delivered, in person or telehealth. Patient-specific characteristics such as Indigenous status, previous FTA behavior, and whether the person was privately funded were also important factors. Discussion and Conclusions:These results indicate that offering appropriate patients the option of telehealth has the potential to reduce FTA. Given the impact of FTA on clinic viability, caseload burden, and waiting lists, telehealth should be explored further and, where possible, should be offered as a routine alternative to in-person appointments.