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Recordatorios de citas para reducir las tasas de ausencia. Un análisis estratificado de su relación costo-efectividad
JAMA
|October 7, 1983
Resumen
Los recordatorios de citas reducen significativamente las tasas de ausencia en la atención primaria. Tanto los recordatorios por carta como por teléfono son efectivos, resultando rentables incluso para pacientes con bajas probabilidades de no presentarse.
Área de la Ciencia:
- Servicios de salud Servicios de salud Investigación Investigación.
- Medicina de la Atención Primaria Medicina de la Atención Primaria.
- Economía de la salud Economía de la salud
Sus antecedentes:
- Las altas tasas de ausencia en la atención primaria conducen a una asignación ineficiente de recursos y a un acceso reducido a la atención.
- Los recordatorios de citas son una estrategia potencial para mitigar las no presentaciones de pacientes.
Objetivo del estudio:
- Evaluar la rentabilidad de las diferentes estrategias de recordatorio en un centro de medicina interna de atención primaria para adultos.
- Para determinar el umbral óptimo para la implementación de recordatorios basados en la probabilidad de no presentación del paciente.
Principales métodos:
- Ensayos controlados aleatorios con 590 citas programadas de seguimiento.
- Comparación de tres grupos: ningún recordatorio, recordatorios generados por computadora y recordatorios telefónicos.
- Análisis económico para evaluar la rentabilidad e identificar los subgrupos de pacientes que se benefician más de los recordatorios.
Principales resultados:
- Las tasas de no presentación disminuyeron del 24% (control) al 14% en todos los grupos de recordatorios.
- Las cartas y los recordatorios telefónicos demostraron una eficacia comparable.
- La rentabilidad varió según el tipo de recordatorio y la probabilidad de que el paciente no se presentara, con cartas informáticas efectivas por encima del 5% y cartas telefónicas / manuales por encima del 11%.
Conclusiones:
- Los recordatorios de citas son una intervención rentable para reducir las no presentaciones en la atención primaria.
- Dirigir recordatorios a pacientes de alto riesgo (probabilidad de no presentarse >20%) maximiza el ahorro, pero una implementación más amplia aún puede ser rentable.
- Las estrategias de recordatorios deben adaptarse a entornos ambulatorios específicos y poblaciones de pacientes.
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