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11.
Corfield L Schizas A Noorani A Williams A 《Annals of the Royal College of Surgeons of England》2008,90(5):377-380
INTRODUCTION
Non-attendance in the out-patient department has financial costs for the NHS and clinical implications to the non-attender and those awaiting an appointment. The aim of this audit was to quantify the percentage of non-attenders at colorectal clinics in a UK teaching hospital, assess which factors affected attendance, establish why individuals fail to attend and to implement appropriate change.PATIENTS AND METHODS
The number of ‘did-not-attend’ patients was recorded initially for 686 appointments. Non-attenders were contacted by post or telephone to ask why this was so. The study was then repeated following telephone reminders to 391 patients due to attend clinic. The ‘did-not-attend’ rates in the two limbs of the completed audit cycle were then compared.RESULTS
The initial study revealed a ‘did-not-attend’ rate of 21%, with significantly more males than females failing to attend (males, 28.6%; females, 16.9%; P = 0.001). The ‘did-not-attend’ rate was not significantly affected by the day of the week, time of appointment or by the weather. There were 51.7% responses to either the postal or telephone questionnaire regarding non-attendance. Of these, 27.7% did not receive an appointment letter or received it after the appointment. Hospital administration problems were cited as accounting for 34.2% of ‘did-not-attends’. In the post-intervention limb, 87 patients (22%) replied to the reminder telephone call, of whom 9 (10%) cancelled their appointment and 78 (90%) confirmed that they would attend. The ‘did-not-attend’ rate fell to 19.7% although this was not a significant reduction.CONCLUSIONS
Telephoning patients before their appointments is labour intensive and did not significantly improve the ‘didnot-attend’ rate. Although hospital administration errors account for a significant number of the ‘did-not-attends’, patients also have a responsibility to notify the hospital if they are unable to attend. 相似文献12.
Vivien Coates Mary Slevin Marian Carey Paul Slater Mark Davies 《Patient education and counseling》2018,101(4):696-702
Objective
to identify the expressed reasons adults with type 2 diabetes decline structured diabetes education (SDE).Methods
cross sectional survey of 335 adults with type 2 diabetes who had declined SDE within the past two years, from across Northern Ireland and England.Standardised instruments comprising The Diabetes Attitude Scale, Diabetes Empowerment Scale (Short Form), and Diabetes Knowledge Test plus a questionnaire to elicit the reasons for declining SDE were used.Results
Mean age 57.6 years (±21.1) 50.7% males, predominantly of White ethnicity (85.7%). They were most frequently invited to attend by a diabetes specialist nurse (36%), general practitioner (27%) or practice nurse (19%).Although a diversity of reasons for declining SDE were cited the most common were; ‘The course was too long’ (47.2%), ‘I have other health problems’ (41.2%) and they had other priorities (33.4%).Hierarchical cluster analysis revealed that expressed reasons for declining SDE were highly individualised.Conclusion
The wide range of reasons that impeded attendance suggests there is no simple solution that will improve attendance rates.Practice implications
In the same way that medical treatment for diabetes is becoming increasingly individualised, educational provision should be encouraged to move away from a one size fits all model. 相似文献13.
Background
Non-attendance at medical appointments is associated with increased patient morbidity and is a significant drain on health service resources. Australian studies have focused on secondary healthcare settings, screening, and interventions to reduce non-attendance.Aims
To explore factors associated with non-attendance in a regional primary care setting.Method
A retrospective cohort of all patients with a scheduled appointment between October 2011 and October 2013 at a regional, primary care clinic providing medical and allied health services in a region of New South Wales (NSW) serving a large Aboriginal population (10.7 per cent). Using multivariate logistic regression, non-attendance was regressed on a range of covariates, including number of appointments per person, gender and ethnicity, and day of the week.Results
The overall proportion of missed appointments was 7.6 per cent. Risk factors for non-attendance were day of the week [Mondays (8.1 per cent), Fridays (8.0 per cent), and Thursdays (7.9 per cent), (χ2(4)= 20.208, p<0.0005], having fewer scheduled appointments [≤5 appointments resulted in 19.1 per cent greater risk of failure to attend (FTA) (95% CI: 11–28%)]; Aboriginality (OR=4.022, 95% CI: 3.263, 4.956), and female gender (OR=1.077; 95% CI 1.024, 1.132). There was a trend toward an interaction between gender and Aboriginality, with Aboriginal females being the group most likely to miss appointments (OR=1.272, 95% CI: 0.949, 1.705).Conclusion
This is the largest study of non-attendance in an Australian primary healthcare setting. While not a typical setting, the study had the advantage of a large, mixed population. The suggested high rates of non-attendance by Aboriginal females have potentially important policy implications. 相似文献14.
Summary
Objectives: To analyze mammography and Pap smear status in Estonia where no organized population-based cancer screening is available.
Methods: 5000 individuals (aged 16–64) were randomly chosen from the national population register; among them, 1755 women filled out
postal questionnaires.
Results: 50% of respondents aged 45–64 reported having taken a mammogram, 51% of women aged 25–64 had the Pap smear at least once in
their lifetime. Corresponding figures for the past two years were 37% and 30%. Irrespective of age, women taking fewer tests
over the past two years were rural workers, unemployed, and health behavior recommendations ignorers. In most cases, initiative
for mammogram came from women, and from the physician in the case of Pap smear. Moderate increase in mammography use occurred
after a project for early detection of breast cancer was launched.
Conclusion: Women must continuously be informed that early detection of breast and cervical cancer is possible. Young women should be
encouraged to ask for Pap testing. Knowledge of family physicians should be improved.
Submitted: 13 February 2006; Revised: 4 October 2006; Accepted: 8 November 2006 相似文献