Analysis of the Effects of a Patient-Centered Rideshare Program on Missed Appointments and Timeliness for MRI Appointments at an Academic Medical Center.
Analysis of the Effects of a Patient-Centered Rideshare Program on Missed Appointments and Timeliness for MRI Appointments at an Academic Medical Center.
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DOI：
10.1016/j.jacr.2020.05.037
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发表时间：
2021-02
影响因子：
4.5
通讯作者：
Flores, Efren J.
中科院分区：
文献类型：
--
作者：
Whorms, Debra S.;Narayan, Anand K.;Pourvaziri, Ali;Miles, Randy C.;Glover, McKinley;Herrington, Jeremy;Saini, Sanjay;Brink, James A.;Flores, Efren J.
关键词：
本研究的目的是评估实施拼车计划前后MRI预约及时性和错过MRI预约率的差异。对一项拼车计划实施9个月后进行回顾性分析，比较实施前后的效果。获得的变量包括人口统计、MRI预约变量和与拼车使用相关的数据。采用描述性统计、线性和逻辑回归分析比较使用拼车计划的患者与(1)实施后未使用拼车计划的患者和(2)实施拼车计划前的患者的人口统计学特征。使用逻辑回归分析分析了与患者相关的当天取消预约的错过预约率。时效性采用线性回归分析。所有的分析都针对潜在的混杂因素进行了调整。在干预后期间安排MRI预约的7707名患者中，151名患者使用了拼车服务（1.95%）。实施拼车后的失约率差异无统计学意义（校正优势比为1.09；95%可信区间为0.93-1.27;P = 0.275）。使用拼车服务的患者更有可能准时到达（调整系数= 13.0；95%置信区间为5.4-20.5;P = 0.001）。老年患者（P = .001）、失业患者（P < .001）和没有商业保险的患者（P < .001）更倾向于使用拼车服务。拼车计划的实施并没有显著降低错过的预约率，但它显著提高了MRI预约的及时性，同时帮助高危患者报告交通障碍。
The aim of this study was to assess the differences in timeliness to MRI appointments and missed MRI appointment rates before and after the implementation of a rideshare program. Retrospective analysis of a rideshare program was performed 9 months after implementation to compare the effects before and after implementation. Variables obtained included demographics, MRI appointment variables, and data related to rideshare use. Descriptive statistics and linear and logistic regression analyses were used to compare demographic characteristics among patients using the rideshare program with (1) those who did not use the rideshare program after implementation and (2) patients before rideshare implementation. Rates of missed appointments derived from patient-related, same-day appointment cancellations were analyzed using logistic regression analyses. Timeliness was analyzed using linear regression analyses. All analyses were adjusted for potential confounders. Of 7,707 patients scheduled for MRI appointments during the postintervention period, 151 patients used the rideshare service (1.95%). There were no statistically significant differences in missed appointment rates after rideshare implementation (adjusted odds ratio, 1.09; 95% confidence interval, 0.93–1.27; P = .275). Patients using the rideshare service were more likely to be on time (adjusted coefficient = 13.0; 95% confidence interval, 5.4–20.5; P = .001). Older patients (P = .001), unemployed patients (P < .001), and patients without commercial insurance (P < .001) were more likely to use the rideshare service. Implementation of a rideshare program did not significantly decrease missed appointment rates, but it significantly improved timeliness to MRI appointments while assisting at-risk patient populations reporting transportation barriers.
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