在初级保健机构的预约不遵守的全球预测因素:系统审查
Azzam Zohair Jad1, Sitah Mohammed Alotaibi2, Amjad Mohammed Asiri3
1College of Medicine, Umm Al-Qura University, Makkah 24268, Saudi Arabia.
Healthcare (Basel, Switzerland)
|March 14, 2026
概括
错过的初级保健预约受患者和系统因素的影响. 解决访问障碍和利用远程医疗的干预措施可以改善遵守.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 公共卫生 公共卫生
- 流行病学 流行病学
背景情况:
- 错过的初级保健预约会对护理连续性,质量产生负面影响,并增加医疗保健成本.
- 全球模式和预测不遵守任命的预测因素报告不一致,需要进行全面审查.
研究的目的:
- 系统地识别,分类和评估初级保健预约不遵守的预测因素的一致性.
- 在世界各地的不同患者群体和医疗保健系统中分析这些预测因素.
主要方法:
- 按照PRISMA指南进行系统审查,搜索主要的数据库 (PubMed/MEDLINE,Scopus,科学网,Cochrane).
- 包括27项观察性研究 (1982-2025年) 分析了超过1300万次预约.
- 使用MINORS工具评估研究质量;由于异质性,结果以叙事形式综合.
主要成果:
- 缺席率在大约5%至31%之间.
- 关键预测因素包括患者层面的因素 (年龄较小,社会经济劣势,心理健康负担),预约层面的因素 (之前的不出席,长时间预订到访问时间) 和系统层面的因素 (访问障碍,安排摩擦).
- 最近的研究表明,远程医疗和护理连续性可以减少缺席.
结论:
- 预约不遵守是由于患者和系统决定因素相互关联而导致的.
- 高风险群体包括年轻,社会经济弱势的患者和患有精神疾病的患者.
- 专注于减少访问摩擦和实施混合远程医疗的干预措施,有望改善遵守.
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