医療サービスの予約保持の遵守を改善するための介入の概要
W M Macharia1, G Leon, B H Rowe
1Design, Measurement, and Evaluation Program, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada.
JAMA
|April 1, 1992
まとめ
患者の予約遵守は,リマインダーと患者エンゲージメント戦略を使用して改善することができます. 郵送されたリマインダー,電話,医師の指示などの介入は,見逃した予約を効果的に減らすことができます.
科学分野:
- 医療サービス 研究 医療サービス
- 行動科学は,行動科学である.
- 医療情報工学 医療情報工学
背景:
- 患者による予約不履行は,医療の効果的な提供に重大な障壁となっている.
- スクリーニング,紹介,診療所訪問への出席率の改善は,患者のアウトカムにとって極めて重要です.
研究 の 目的:
- ランダム化試験のメタ解析を通じて,医療予約に対する患者の遵守を改善するためのさまざまな戦略の有効性を定量的に評価する.
主な方法:
- MEDLINEとPSYCHLITのデータベースの体系的な文献検索が行われました.
- 監督ケアのための診察出席率を改善するための介入に関する定量的なデータを含むランダム化試験が含まれています.
- プーリングされたオッズ比率 (ORs) を使用したデータ抽出と分析は,2人の独立したレビュー者によって行われました.
主要な成果:
- 患者の平均順守率は58%でした.
- 郵送によるリマインダー (OR,2.2) と電話によるプロンプト (OR,2.9) は,打ち切られた予約を大幅に削減しました.
- 他の効果的な戦略には,指向声明 (OR,2.9),患者との契約 (OR,1.9),医師の提示 (OR,1.6) が含まれていた.
結論:
- メールのリマインダー,電話のプロンプト,医師のリマインダーなどの戦略は,見逃した予約を効果的に減らすことができます.
- 患者指向と契約は,医療の予約遵守を改善するための貴重な介入でもあります.
- これらの発見は,診療所での診察予約の維持が,患者の従順性の信頼性の高い指標である診療所に適用できます.
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