基於健康信念模式之預約提醒對出席率之影響-以體脂肪量測為例

Effects of Appointment Reminders based on Health Belief Model on Attendance Rates-A Case Study of Body Fat Measurement

陳建文(Chien-Wen Chen)

指導教授 ： 梁曉帆

國立臺北科技大學/管理學院/工業工程與管理系碩士班/碩士(2014年)

摘要

醫院透過預約制度提升病患的醫療服務品質，但是有預約制度就會發生失約，以醫療檢查為例，若病患與醫師預約檢查的時段內並未出現，且沒有事先取消預約，稱為檢查失約。病患失約會造成醫療資源的閒置與醫院收入減少，對於門診品質也有負面影響。引起失約的原因有很多，較常見的是忘記、睡過頭或記錯時間。對於失約的改善，主要的研究是針對不同的改善手法，如宣導、制裁或提醒等方式，改變病患行為，因此本研究模擬醫院預約檢查的情境，與受測者預約測量體脂肪之時間與地點，透過Eclipse開發平台設計開發手機提醒應用程式，分別有不提醒、一般提醒與加入健康信念之提醒三種方式，透過實驗獲得受測結果的資料，探討健康信念態度與不同提醒模式的應用程式對於出席率與不同提醒模式喜好程度的影響。研究發現，提供加入健康信念之提醒的受測族群出席率最高，不提醒的受測族群出席率最低，而提供一般提醒的受測族群出席率介於其中。此外，健康信念態度較積極的受測者較喜好加入健康信念之提醒模式。本研究希望能夠透過此研究結果提供後續手機提醒應用程式研究與設計之建議，達到降低失約率的效果。

關鍵字

預約檢查 ； 提醒應用程式 ； 失約

並列摘要

Appointment systems are one of the approaches to improve the quality of patient care, but there is an appointment, there is an absence. For example, no-shows in medical examination are defined as the absence of patients in the appointed times without any notice in advance. No-shows result in the loss of hospital revenue, the waste of medical resources, and the impairment of healthcare quality. There are many reasons for no-show, such as forgetting, oversleeping and mistaking appointment times. Through the change of patient behavior, reminder is one of several main approaches to remedy these types of no-shows. Therefore, this study aims to investigate the effects of appointment reminders on attendance rates with a simulated examination appointment designed to examine participants' body fat. A reminder application was developed through the Eclipse development platform. The mode of appointment reminders was served as the first independent variable with three levels. They were no reminder, reminder with basic information and reminder with basic and healthcare information. The second independent variable was participants' health belief attitude measured by a questionnaire. Attendance rates and preferences on the reminder modes were the dependent variables. Results showed that participants provided by the reminder with basic and healthcare information had the highest attendance rate, whereas the participants without any reminder provided had the lowest attendance rate. Moreover, participants with higher scores on the health belief attitude questionnaire preferred the reminder with basic and healthcare information. The findings of this study should be able to offer suggestions for further research on the design of appointment reminders, and ultimately to increase attendance rates.

並列關鍵字

Appointed Examination ； Reminder Applications ； No Shows

參考文獻

1.吳明蒼、黃恰鑽 ，「病人預約了，為何不來?」，當代醫學，第17卷，第2期，1990，第98-100頁。

2.王文利、林文真、趙文忠、陳楚杰、林恆慶，「某醫學中心門診失約病人的特性及失約問題之探討」，醫護科技學刊，第5卷，第4期，2003，第309-319頁。

3.H. Killaspy, S. Banerjee, M. King, "Prospective controlled study of psychiatric out-patient non-attendance," Characteristics and outcome. British Journal of Psychiatry, Vol. 176, 2000, pp. 160–165.

4.L. F. Sparr, M. C. Moffitt, M. F. Ward, "Missed psychiatric appointments: Who returns and who stays away," American Journal of Psychiatry, Vol. 150, no. 5, 1993, pp. 801-805.

6.K. McCarthy, H. M. McGee and C. A. O’BOYLE, "Outpatient clinic waiting times and non-attendance as indicators of quality," Psychology, Health & Medicine, Vol. 5, No. 3, 2000, pp. 287-293.