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Analysis of the Effect of Patients' Clinical Conditions on No-Shows

외래 환자의 임상특성이 예약 부도에 미치는 영향 분석

  • Lee, Sangbok (Department of Industrial and Management Engineering, College of Engineering, Hansung University) ;
  • Park, Kitaek (Department of Industrial and Management Engineering, College of Engineering, Hansung University) ;
  • Chung, Kwanghun (College of Business Administration, Hongik University)
  • Received : 2017.10.13
  • Accepted : 2017.11.06
  • Published : 2017.11.30

Abstract

This study focuses on analyzing no-shows associated with patients' clinical characteristics described by diagnoses in their medical data. A dataset of 7,055 patient-records from a Veterans hospital in the United States was used to test if there is difference on no-shows along with each patient's diagnosed diseases and the number of diagnoses. Patients with mental diseases such as drug dependence abuse and major depression, and chronic diseases such as hypertension are more likely to no-show. In comparisons with the number of diagnoses, the no-show decreases as the number of diagnoses increases up to four and doesn't change significantly afterwards. We provide managerial insights on clinical operations problems from statistical analysis. We believe that our results can be used to develop appropriate solutions on no-shows in clinics.

본 논문에서는 환자들의 임상특성이 예약 부도에 미치는 영향을 분석하고자 한다. 미국의 한 보훈병원에 있는 7,055명 환자들의 진단 상병명과 그들의 예약 부도 데이터를 이용하여 진단 상병에 따른 예약 부도의 차이, 진단 상병의 개수에 따른 차이에 대해서 분석 및 비교를 실시하였다. 약물 중독, 우울증과 같은 정신질환과, 고혈압과 같은 만성 질환에서 예약 부도가 유의하게 높게 나타났다. 진단 상병의 개수가 증가할수록 예약 부도가 감소하는 것을 확인할 수 있으나, 진단 상병의 개수가 4개를 넘어서면 예약 부도가 통계적으로 유의하게 감소하지 않는 것으로 나타났다. 이러한 통계적 분석 과정을 통해 의료 환경에서 수행하고 있는 진료 및 예약 부도 관리의 문제점을 식별하여 제시하였다. 본 논문의 결과는 병원의 예약 부도에 대한 해결책을 찾는데 이용될 수 있다고 판단된다.

Keywords

References

  1. Atun, A. R., Sittampalam S. R., and Mohan, A., "Uses and Benefits of SMS in Healthcare Delivery," Centre for Health Management, Imperial College London, UK, 2005.
  2. Belardi, F. G., Weir S., and Craig F. W., “A controlled trial of an advanced access appointment system in a residency family medicine center,” Family Medicine, Vol. 36, No. 5, pp. 341-345, 2004.
  3. Chung, K. and Min, D., “Staffing a service system with appointment-based customer arrivals,” Journal of the Operational Research Society, Vol. 65, No. 10, pp. 1533-1543, 2014. https://doi.org/10.1057/jors.2013.110
  4. Daggy et al., “Using no-show modeling to improve clinic performance,” Health Informatics Journal, Vol. 16, No. 4, pp. 246-259, 2010. https://doi.org/10.1177/1460458210380521
  5. Davis et al., "Large-scale no- show patterns and distributions for clinic operational research," Healthcare, Vol. 4, No. 1, p. 15, 2016.
  6. George, A. and Rubin, G., “Non-attendance in general practice: A systematic review and its implications for access to primary health care,” Family Practice, Vol. 20, No. 2, pp. 178-184, 2003. https://doi.org/10.1093/fampra/20.2.178
  7. Hamilton, W., Round, A., and Sharp, D., "Patient, hospital, and general practitioner characteristics associated with non-attendance: A cohort study," British Journal of General Practice, Vol. 52, No. 477, pp. 317-319, 2002.
  8. Hwang, J. I., “Factors influencing consultation time and waiting time of ambulatory patients in a tertiary teaching hospital,” Quality Improvement in Health Care, Vol. 12, No. 1, pp. 6-16, 2006.
  9. Kang, H. J., "National-level use of health care big data and its policy implications," Health and Welfare Policy Forum, Vol. 8, pp. 55-71, 2016.
  10. Kim, S. and Giachetti, R., "A stochastic mathematical appointment overbooking model for healthcare providers to improve profits," IEEE Transactions on Systems, Man, and Cyberbetics-Part A: Systems and Humans, Vol. 36, No. 6, pp. 1211-1219, 2006. https://doi.org/10.1109/TSMCA.2006.878970
  11. Kopach et al., “Effect of clinical characteristics on successful open access scheduling,” Health Care Management Science, Vol. 10, No. 2, pp. 111-124, 2007. https://doi.org/10.1007/s10729-007-9008-9
  12. Kwon, S. T., Lee, Y. S., Han, E., and Kim, T. H., "Factors associated with no-show in an academic medical center," Korean Public Health Research, Vol. 41, No. 2, pp. 29-46, 2015.
  13. Lacy, N. L., Paulman, A., Reuter, M. D., and Lovejoy, B., "Why we don't come: Patient perceptions on no-shows," Annals of Family Medicine, Vol. 2, No. 6, pp. 541-545, 2004. https://doi.org/10.1370/afm.123
  14. LaGanga L. and Lawrence S., “Appointment overbooking in health care clinics to improve patient service and clinic performance,” Production and Operations Management, Vol. 21, No. 5, pp. 874-888, 2012. https://doi.org/10.1111/j.1937-5956.2011.01308.x
  15. Lasser, K. E., Mintzer, I. L., Lambert, A., Cabral, H., and Bor, D. H., “Missed appointment rates in primary care: the importance of site of care,” Journal of Health Care for the Poor and Undeserved, Vol. 16, No. 3, pp. 475-486, 2005. https://doi.org/10.1353/hpu.2005.0054
  16. Lee, S. and Yih, Y., “Analysis of an open access scheduling system in outpatient clinics: A simulation study,” Simulation: Transactions of The Society for Modeling and Simulation International, Vol. 86, No. 8-9, pp. 503-518, 2010. https://doi.org/10.1177/0037549709358295
  17. Lee, S., Min, D., Ryu, J., and Yih, Y., "A simulation study of appointment scheduling in outpatient clinics: open access and overbooking," Simulation: Transactions of The Society for Modeling and Simulation International., Vol. 89, No. 12, pp. 1459-1473, 2013. https://doi.org/10.1177/0037549713505332
  18. Min, D. and Koo, H., “no-show related factors for outpatients at a hospital,” The Journal of Society for e-Business Studies, Vol. 22, No. 1, pp. 37-49, 2017. https://doi.org/10.7838/jsebs.2017.22.1.037
  19. Murray, M. and Tantau, C., “Same-day appointments: Exploding the access paradigm,” Family Practice Management, Vol. 7, No. 8, pp. 45-50, 2000.
  20. Nguyen, D. L., Dejesus, R. S., and Wieland, M. L., “Missed appointments in resident continuity clinic: Patient characteristics and health care outcomes,” Journal of Graduate Medical Education, Vol. 3, No. 3, pp. 350-355, 2011. https://doi.org/10.4300/JGME-D-10-00199.1
  21. O'Hare C. D. and Corlett, J., "The outcomes of open-access scheduling," Family Practice Management, Vol. 11, No. 2, pp. 35-38, 2004.
  22. Parikh et al., “The effectiveness of outpatient appointment reminder systems in reducing no-show rates,” American Journal of Medicine, Vol. 123, No. 6, pp. 542-548, 2010. https://doi.org/10.1016/j.amjmed.2009.11.022
  23. Paul, J. and Hanna, J. B., "Applying the marketing concept in health care: the no-show problem," Health Marketing Quarterly, Vol. 14, No. 3, pp. 3-17, 1997. https://doi.org/10.1300/J026v14n03_02
  24. Peeters, F. P. and Bayer, H., "no-show for initial screening at a community mental health centre: Rate, reasons, and further help-seeking," Social Psychiatry and Psychiatric Epidemiology, Vol. 34, No. 6, pp. 323-327, 1999. https://doi.org/10.1007/s001270050151
  25. Samuels et al., “Missed appointments factors contributing to high no-show rates in an urban pediatrics primary care clinic,” Clinic Pediatrics, Vol. 54, No. 10, pp. 976-982, 2015. https://doi.org/10.1177/0009922815570613
  26. United States Department of Veterans Affairs, "Audit of Veterans Health Administration's Efforts to Reduce Unused Outpatient Appointments," U.S. Department of Venterans Affairs Office of Inspector General, Washington, DC, USA, 2008.
  27. Yoon, J., "Waste of the worth of 2.5 trillion KRW in clinical resources by no-shows," The Hospital Newspaper, April 27, 2016.