某醫學中心門診失約病人的特性及失約問題之探討

目標：本研究之目的在瞭解門診失約病人的特性、失約的原因、失約病人對掛號與預約制度的認知及意見，進而研擬降低門診病人失約的可行方案。方法：本研究採立意取樣的方式選擇台灣地區某醫學中心的一週預約門診病人34,428人為研究對象；且為了瞭解病人失約的原因及失約病人對掛號與預約制度的認知及意見，再從掛號人數最多的前十科的3,959個失約病人中，以隨機抽樣的方式每科抽出60人，共600人，以電話訪問的方式收集資料，各科訪滿30個有效樣本即停止，共有效樣本300人。結果：（一）在影響門診病人是否失約的因素分析中發現，在控制其他變項後，年齡、醫師職級、預約方式、看診時段、醫師是否代診、失約累積次數等五項變項，對於門診病人是否失約之影響達統計上的顯著水準。（二）在病人失約的原因及失約病人對掛號與預約制度的認知及意見方面發現，病人失約原因前三名依序為忘了預約時間（34.3%）、沒有空來（17.3%）及住院中的（8.7%），有58%的門診失約病人不知道有取消預約掛號的相關規定，有93.3%門診失約病人認為於門診前一日提醒病人隔日有預約，對解決門診失約的問題有效。結論：建議個案醫院可以考慮在醫師預約的回診單上，註明取消預約掛號的相關規定及電話號碼，以提醒病人準時履約或取消預約。

關鍵字

掛號；門診病人；預約

並列摘要

Purpose: This study examined characteristics, reasons, knowledge and attitudes toward the register system for ambulatory patients who fail to show up for appointments for treatment and moreover proposed some methods of lowering the possibility of missed appointments. Methods: This study used convenient sampling to select 34,428 ambulatory patients who failed to show up for their scheduled appointments at a medical center n Taiwan. To understand the knowledge and attitudes toward the register system of these patients, 3,959 patients who failed to show up for their scheduled appointments were selected from ten departments with the largest numbers of registered patients. A random selection then was conducted to 60 patients from among these 3,959 patients. A telephone interview with the fires 30 selected patients also was performed to collect data. The final sample contained 300 patients. Results: This study OR found that five factors were significantly related to appointment failure, namely patient age, seniority of the physician, appointment method (phone or internet), appointment time, whether a scheduled physician was replaced, and accumulated number of failed appointments. The most common reasons for missing appointments were forgetting appointment time (34.3%), being too busy to show up (17.3), and being hospitalized (8.7) Notably, 58% of patients who missed appointments did not know that appointments could be cancelled in advance Moreover, 93.3% of patients who missed appointments believed that a reminder about their appointment one day in advance could prevent patients from missing appointments. Conclusions: This study suggests that hospitals should include rules and phone numbers relevant to appointment cancellation on referral sheets to remind patients to show up on time or to educate patients about how to cancel an appointment.