Prevalence, predictors and economic consequences of no-shows.
Prevalence, predictors and economic consequences of no-shows.
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DOI：
10.1186/s12913-015-1243-z
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发表时间：
2016-01-14
影响因子：
2.8
通讯作者：
Sharafkhaneh A
中科院分区：
文献类型：
--
作者：
Kheirkhah P;Feng Q;Travis LM;Tavakoli-Tabasi S;Sharafkhaneh A
患者不参加门诊预约（无显示）显著影响分娩，护理成本和资源规划。我们的目的是评估患者缺席的患病率、预测因素和经济后果。这是一项回顾性队列研究，使用1997-2008财政年度的行政数据库。我们在一家大型医疗中心的管理数据库中搜索了缺勤频率和费用。此外，我们还估计了另外10家地区医院的缺勤率和费用。我们研究了12年来初级保健和各种亚专科设置的缺勤率，每月和季节性缺勤趋势，实施提醒系统的效果以及错过预约的经济影响。10家主要诊所的平均失诊率为18.8%(2.4%)，其中亚专科诊所的失诊率最高。与普通初级保健诊所（PCP）相比，女性诊所的缺勤率较高，老年诊所的缺勤率较低。尽管通过集中电话提醒降低了缺勤率（从16.3%下降到15.8%），但缺勤率仍保持在较高水平。2008年，每位病人的平均缺席费用为196美元。我们的数据表明，缺勤给医疗保健系统带来了沉重的负担。此外，提醒系统的实施只略微降低了缺勤率。
Patients not attending to clinic appointments (no-show) significantly affects delivery, cost of care and resource planning. We aimed to evaluate the prevalence, predictors and economic consequences of patient no-shows. This is a retrospective cohort study using administrative databases for fiscal years 1997–2008. We searched administrative databases for no-show frequency and cost at a large medical center. In addition, we estimated no-show rates and costs in another 10 regional hospitals. We studied no-show rates in primary care and various subspecialty settings over a 12-year period, the monthly and seasonal trends of no-shows, the effects of implementing a reminder system and the economic effects of missed appointments. The mean no-show rate was 18.8 % (2.4 %) in 10 main clinics with highest occurring in subspecialist clinics. No-show rate in the women clinic was higher and the no-show rate in geriatric clinic was lower compared to general primary care clinic (PCP). The no-show rate remained at a high level despite its reduction by a centralized phone reminder (from 16.3 % down to 15.8 %). The average cost of no-show per patient was $196 in 2008. Our data indicates that no-show imposed a major burden on this health care system. Further, implementation of a reminder system only modestly reduced the no-show rate.