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No-Show Related Factors for Outpatients at a Hospital

병원 외래환자의 예약부도 요인

  • Min, Daiki (School of Business, Ewha Womans University) ;
  • Koo, Hoonyoung (School of Business, Chungnam National University)
  • Received : 2017.01.02
  • Accepted : 2017.01.16
  • Published : 2017.02.28

Abstract

In order to maximize the efficiency and the quality of care in a hospital, hospitals in general operate by appointments. Patient no-shows or missed appointments waste the time of staffs who prepare for appointments, deprive patients of needed care, and increase burden on clinic capacity. The purpose of this study is to examine the importance and significance of factors that affect patient no-shows. The actual data of 50,000 outpatient appointments is compiled and analyzed from a VAMC in the United States with aims to identify the factors that contribute to outpatient no-shows and to draw meaningful implications. Random forest along with logistic regression analysis identify the factors affecting no-shows; appointment leadtime, show-up rate, travel distance, no-show rate in previous period, patient age, severity, complexity of disease, chronic pain, depression, drug dependence. The appointment leadtime, show-up rate, travel distance and previous no-show rate can be improved by enhancing SMS pre-notification and by improving afterwards telephone counseling. For other factors, it needs to study on the service differentiation with the characteristics of each patient group.

병원 진료의 효율성과 진료 품질의 극대화를 위해 진료예약을 시행하고 있다. 그러나 예약일에 방문하지 않는 예약부도로 인해 의료서비스 자원이 낭비되고 다른 환자의 진료기회를 박탈하는 등 현대 병원 운영에서 주요한 이슈의 하나로 떠오르고 있다. 이러한 예약부도의 원인을 분석하기 위해 미국의 한 보훈병원의 5만 건 진료예약 데이터를 대상으로 예약부도 요인의 중요도와 유의성을 검정하였다. 랜덤 포레스트와 로지스틱 회귀분석 결과, 예약대기시간, 방문율, 내원거리, 예약부도율, 환자 나이, 중증도, 질병의 복합도, 만성통증, 우울증, 약물의존 등이 주요한 원인으로 파악되었다. 예약대기시간과 방문율, 내원거리, 예약부도율은 SMS 사전 통지를 강화하고 사후 전화 상담을 통해 점진적으로 개선 가능할 것으로 판단되며 기타 요인에 대해서는 환자 그룹별로 차별화된 대응방안을 구성하는 것을 고려해 볼 수 있다.

Keywords

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