从统计数据到故事:了解错过就诊的复杂情况。

IF 2.5 Q2 PRIMARY HEALTH CARE BJGP Open Pub Date : 2024-10-29 Print Date: 2024-10-01 DOI:10.3399/BJGPO.2024.0007
Lea Charton, Francis Gatier, Chloe Delacour, Camille Lépine
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引用次数: 0

摘要

背景:研究表明,在法国和英国,有5%至10%的全科医生(GPs)预约是无人接诊的。爱尔兰的一项综合研究将失约与短期死亡风险增加联系在一起,促使人们进一步调查缺席背后的原因。目的:本研究试图在城市医疗中心的背景下,深入探讨失约的根本原因:本研究采用混合方法,将定性电话访谈与定量病历分析相结合。研究的重点是 15 天内未到城市医疗中心就诊的病人:访谈指南收集了有关导致失约情况的数据,并探讨了患者的健康社会决定因素。此外,还通过医疗记录了解了患者的社会经济背景:在 53 名失约者(占所有预约者的 4.9%)中,有 22 名患者接受了访谈。特别健康计划受益人(占样本的 68%)认为社会经济不稳定,包括工作时间不稳定、社会孤立和有多项承诺,是他们未赴约的原因。对于非 SHC 受益人来说,健忘是主要原因。值得注意的是,有 36% 的人披露了家庭暴力史。医生进行的回顾性分析认为,超过四分之一的失约具有重要意义:研究结果表明,失约会凸显社会不平等,强调医疗保健必须与患者的时间现实相一致。识别遭受过暴力的患者并将失约作为后续电话的触发因素,似乎是加强医疗服务和减少健康不平等的有效策略。
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From statistics to stories: understanding the complex landscape of missed medical appointments. A mixed-methods pilot study.

Background: Research suggests that in both France and the UK, between 5% and 10% of appointments with GPs are unattended. A comprehensive Irish study linked missed appointments with an increased short-term risk of mortality, prompting further investigation into the reasons behind absenteeism.

Aim: To delve into the underlying causes of missed appointments, within the context of an urban health centre.

Design & setting: Using a mixed-method approach, this study combines qualitative telephone interviews with quantitative analysis of medical records. The study focuses on patients who failed to attend appointments at an urban health centre in France over a 15-day period.

Method: The interview guide collected data on circumstances leading to missed appointments and explored patients' social determinants of health. Additionally, quantitative data, including patients' socioeconomic backgrounds, were extracted from medical records.

Results: Among 53 missed appointments (4.9% of all scheduled), 22 patients were interviewed. State health coverage (SHC) beneficiaries (68.2% of the sample) cited socioeconomic instability, including precarious work hours, social isolation, and multiple commitments, as reasons for non-attendance. For non-SHC beneficiaries, forgetting the appointment or failing to cancel it after self-resolution of the health issue was one of the main causes. Remarkably, 36.4% disclosed that they had experienced domestic violence. During the qualitative interview, patients were offered the opportunity to reschedule appointments, and a retrospective analysis by physicians found that over a quarter of the missed appointments were classified as 'capital appointments', meaning their absence could have significantly harmed the patient's health.

Conclusion: The findings indicate that missed appointments can highlight social inequality, emphasising the need to align health care with patients' temporal realities. The identification of patients who have experienced violence and the use of missed appointments as triggers for follow-up calls seem to be promising strategies to enhance care and mitigate health inequalities.

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来源期刊
BJGP Open
BJGP Open Medicine-Family Practice
CiteScore
5.00
自引率
0.00%
发文量
181
审稿时长
22 weeks
期刊最新文献
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