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Results for “Appointments and Schedules”

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At least 19 recordsLinked to original sources
PubMed1979

Failed appointments: a review.

Failed appointments disrupt office operations. Most studies involved hospital clinics with low socioeconomic populations, which have shown fail rates between 19 and 28 percent. Family practice centers report fail rates which vary from 5 to 11 percent. Young adults, adults with young children, and patients in low socioeconomics groups tend to increase the fail rate. Sex and race are probably not a factor. Reasons for failing appointments include communication problems, the absence of a sense of urgency for keeping the appointment, and the lack of a personal physician. An interval greater than two weeks between appointment scheduling and the appointment date places patients most at risk for failing the appointment. Mail and telephone reminders significantly reduced the fail rate and are cost efficient. Incentives are also used in reducing the fail rate. By examining the process, the patients, the provider, and the environment with respect to appointment keeping behavior, a more quantitative approach to research on the subject can be effected.

Ambulatory Care↗
PubMed1976

Lowering appointment failures in a neighborhood health center.

Failure to keep appointments constitutes a barrier to the delivery of continuous care in many comprehensive health care facilities. At a neighborhood health center in Pittsburgh, Pa., 336 appointments were studied to determine whether reminder letters or reminder calls could improve compliance with appointments scheduled more than three weeks in advance. The failure rate in the control group was 38 per cent compared with 10 per cent for the letter reminder group and 9 per cent for the telephone reminder group. The differences in kept, cancelled, and failed rates between letter and telephone groups were not statistically significant (p greater than .05). The kept rate increased with patient's age in all three groups. Complicance was not affected by sex of the patient, length of time that appointment was scheduled in advance, or day of the week. Compliance was greatest among appointments scheduled for chronic illness follow-up and physical examinations, and least among appointments scheduled for "screening."

Adolescent↗
PubMed1977

Effective patient scheduling.

Patient appointments and scheduling of patients and physicians are the first step in any health-care delivery system. This paper deals with the conventional method usually found in preprinted appointment books, and the "wave" method. A method of testing this system is any practice environment is described, together with the comparative benefits of the wave method over the conventional method of scheduling. This paper also exemplifies one kind of research that can be accomplished in the private, ambulatory sector of medicine.

Appointments and Schedules↗
PubMed1977

Differential effects of a phone reminder on appointment keeping for patients with long and short between-visit intervals.

In the Harborview Medical Center pediatrics clinic, we were interested in testing whether a phone call would increase appointment-keeping behavior and whether the call would have a differential effect depending on the interval between appointments. Ninety-eight patients were studied who had scheduled appointments 3 to 264 days in advance and still had these appointments 3 days prior to appointment time. Patients who were randomly placed in an experimental condition received a reminder call. Control patients received no call. The results indicate some difference between compliance rates of the experimental and control conditions in the expected direction (X2=3.715, df=1, p less than .05). Patients whose visits were scheduled more than 14 days prior to the appointment time ("long-interval" patients) were separated from patients whose appointments were scheduled more recently. A significant difference in appointment-keeping rates between the experimental and control groups was found (X2=4.908, df=1, p less than .025), but only for the "long-interval" patients. Therefore, the use of a phone cue is particularly recommended for these patients.

Adult↗
PubMed1977

A Monte Carlo computer model to investigate patient scheduling.

A Monte Carlo computer model was developed to investigate various types of patient appointment schedules for a single channel queue. Input parameters included the incidence of no-shows, the rate of unscheduled walk-ins, the frequency distribution of physician examination times, and the string of appointment times. The results included the frequency distributions of physician utilization rates and the total waiting time of all patients. Five hospital clinics were simulated. Even increment schedules yielded the best trade-off between physician utilization and patient waiting.

Appointments and Schedules↗
PubMed1979

Correlations between appointment keeping and reorganization of hospital ambulatory pediatric services.

Over a period of 13 months before and after a university-affiliated hospital's daytime ambulatory pediatric facility was upgraded from an episodic care clinic to a primary care unit, 260 subjects were interviewed in an attempt to predict compliance with return appointment scheduling. The parents of patients more than 10 years of age were the least compliant, but most of the differences in compliance appeared due to the subject's evaluation of the diagnostic ability, thoroughness, and sympathy of the physician at the initial visit. Although no changes were noted in the subjects' demographic characteristics or in their general opinions of ambulatory health care delivery or of attitudes desired of physicians, their evaluations of recent visits improved and the missed appointment rate declined by 46% in the course of the study. Moreover, the pediatric house officers, who evaluated the patients, demonstrated an increased ability to assess the characteristics the subjects found important in physicians. Improvements are still needed, especially in the amount of communication between house officers, patients, and parents, but heeding clients' opinions about the provision of primary health care may help to make missed appointment rates negligible.

Adolescent↗
PubMed1978

The no-show patient in the model family practice unit.

Appointment breaking by patients causes problems for the physician's office. Patients who neither keep nor cancel their appointments are often referred to as "no shows." Twenty variables were identified as potential predictors of no-show behavior. These predictors were applied to 291 Family Practice Center patients during a one-month study in April 1977. A discriminant function and multiple regression procedure were utilized ascertain the predictability of the selected variables. Predictive accuracy of the variables was 67.4 percent compared to the presently utilized constant predictor technique, which is 73 percent accurate. Modification of appointment schedules based upon utilization of the variables studies as predictors of show/no-show behavior does not appear to be an effective strategy in the Family Practice Center of the Community Hospital of Sonoma County, Santa Rosa, due to the high proportion of patients who do, in fact, show. In clinics with lower show rates, the technique may prove to be an effective strategy.

Appointments and Schedules↗
PubMed1979

Incentive effects of choosing a therapist.

Investigated the effects of offering clients (N = 55) a choice of therapeutic style on show rate and reactions to the initial interview. Individuals who called for an appointment were assigned randomly to Choice and Attention-Control conditions. Choice Ss were informed that they would be assigned to a therapist who identified with one of two descriptions of therapy styles from which they could choose. Based on this choice, these persons were scheduled with the next therapist in line who had identified him/herself with the selected style. Attention-Control clients were informed about the range of services available at the clinic and paired with a therapist regardless of style on the usual rotating basis. A significantly higher proportion of Choice than Attention-Control Ss kept their schedules appointments. However, no significant differences were found on client and therapist evaluations of the initial interview.

California↗
PubMed1978

The productivity potential of physicians' assistants: an integrated approach to analysis.

Although many previous analytical studies indicate that physicians' assistants can substantially increase productivity and reduce costs, the utilization of physicians' assistants in ambulatory health care settings has grown at a disappointing rate. This apparent discrepancy may be explained in part through close examination of the models used in the analytical studies. This paper describes the limitations of previous studies and shows how analysis can be improved through the use of a combined optimization-simulation model. The model is applied to a hypothetical example to demonstrate how productivity and income benefits can be overstated, and to test the sensitivity of such benefits to a range of management policies for the ambulatory care practice regarding patient load, physical resources, appointment scheduling, and more flexible assignment of providers to patients.

Computers↗
PubMed1979

Disulfiram for the treatment of alcoholism. An evaluation in 128 men.

One hundred twenty-eight alcoholic men were assigned randomly to receive either a regular dose of disulfiram (250 mg), a pharmacologically inactive dose (1 mg), or no disulfiram. There were no statistically significant differences among the three treatment groups in total abstinence, percentage of drinking days, days worked, family stability (living with same relative), or percent of scheduled appointments kept. However, 21% of those who received the regular dose of disulfiram and 25% who received the pharmacologically inactive dose remained abstinent, whereas only 12% of those who received no disulfiram did so. These results indicate that disulfiram may be of limited value in the treatment of alcoholism, fear of the disulfiram-ethanol reaction is important in preventing drinking, and patients willing to take disulfiram are more likely to be abstinent if given the drug. We also found that complete abstinence correlated significantly with compliance and obtaining employment.

Adult↗
PubMed1978

Patient participation in a hypertension control program. Hypertension Detection and Follow-up Program Cooperative Group.

In the Hypertension Detection and Follow-up Program, the largest standardized hypertension detection, follow-up, and treatment program to date in the United States, participation rates have been high at all stages. More than 75% of those with suspected hypertension at screening attended follow-up rescreening, and more than 80% of the 5,314 hypertensive patients assigned to program treatment remained active at the end of one year. Differences in participation rates were generally small. To accomplish this, intensive efforts were required to maximize attendance, and the program was shaped to reduce known barriers to initial attendance and long-term adherence. Against the background of a high overall program response rate for all sex-race groups, factors that might be associated with variations in response were examined: age, socioeconomic characteristics, health status, and appointment schedule.

Black People↗