Who Fails Appointments at Psychiatric Clinics in a General Hospital in Taiwan?

某一綜合醫院精神科門診缺席病人之特性分析

10.29478/TJP.200903.0007

周佑達(Yu-Ta Chow)；吳麗琴(Li-Chin Wu)；陳景彥(Ching-Yen Chen)

順從性 ； 門診病人 ； 門診缺席 ； compliance ； outpatients ； missed appointments

台灣精神醫學

23卷1期（2009 / 03 / 01）

62 - 71

英文

目的：瞭解精神科門診出缺席病人之差異。方法：收集自民國95年12月間，北部某都會區區域綜合醫院的精神科門診預約病人，以回溯性病歷回顧的方式，記錄病人的性別、年齡、臨床診斷，以及該預約是初診或複診，再以描述性與推論性統計進行分析，評估出缺席病人在這四個變項上是否有差異存在。結果：總共有970位預約病人，其中有177位缺席，缺席率為18.2%。出缺席病人的性別並無顯著差異，但在年齡、診斷與初複診有顯著差異，年紀較輕、罹患憂鬱症、以及複診的病人較容易缺席。缺席的病人中有86位在3個月之內回診，回診率48.6%。結論：精神科門診病人的缺席率會隨年齡、臨床診斷，以及約診類型而有所差異。

Objectives: The aims of this study were to identify and to analyze the characteristics of the patients who missed appointment at psychiatric clinics in a general hospital. Methods: We collected the appointment data in a general hospital during the month of December 2006. Patients' demographic data, diagnoses, and whether the appointment of initial or follow-up clinic visits were recorded retrospectively from patients' medical records. With descriptive and analytical statistics, we compared the differences between patients who kept and those who missed their appointments. We also identified the reasons for failure to keep appointments. Results: We found that 970 patients who made appointments over the month. Of these, 177 patients were found to miss their appointments with a rate of absence of 18.2%. No significant sex difference was found between those two groups. However, we found that the patients who missed their appointments tended to be younger, to have more diagnosis with depressive disorders, and they were likely to miss a follow-up appointment, and that 86 patients returned to psychiatric clinics within three months of their missing the index appointments (48.6%). Conclusion: In our study, younger patients, patients with depressive disorders, and follow-up patients had a higher rate of failed clinic appointments. These results of this study can be used to identify patients who are at risk of not showing up their appointments, and to design interventions to reduce the risk factors for nonattendance.

1. Alex JM,Thomas S(2007).A comparatives survey of missed initial and follow-up appointments to psychiatric specialties in the United Kingdom.Psychiatr Serv,58,868-871.
2. American Psychiatric Association(2000).Text Revised (DSM-IV-TR).Washington DC:American Psychiatric Publishing, Inc..
3. Barry C,Douglas S,Manuel M(1991).Who misses appointments? an empirical analysis.Can J psychiatry,36,223-225.
4. Bollini P,Pampallona S,Kupelnick B,Tibaldi G,Munizza C(2006).Improving compliance in depression: a systematic review of narrative reviews.J Clin Pharm Therap,31,253-260.
5. Cohen S,Kuhn KU,Bender S(2007).Sexual impairment in psychiatric inpatients: focus on depression.Pharmacopsychiatry,40,58-63.
6. Cuijpers P,Schoevers RA(2004).Increased mortality in depressive disorders: a review.Curr Psych fatty Rep,6,430-437.
7. DiMatteo MR,Lepper HS,Croghan W(2000).Depression is a risk factor for noncompliance with medical treatment.Arch Intern Med,160,2101-2107.
8. Elgie R(2006).A patient and primary care perspective: a patient's perspective on the treatment of depression.J Clin Psychiatry,68,38-40.
9. Gazdag G,Sebestyen G(2007).Psychiatric disorders leading to noncompliance in a consultative psychiatric practice (Hungrian).Orvosi Hetilap (Budapest),148,509-512.
10. Gina RK,Barbara MR,Xiaoyan W(2002).Factors associated with missed first appointments at a psychiatric clinic.Psychiatr Serv,53,1173-1176.
11. Henry C,Demotes-Mainard J(2006).SSRIs, suicide and violent behavior: is there a need for a better definition of the depressive state.Curr Drug Saf,1,59-62.
12. James F,Dotter MC(1998).Missed and canceled appointments at a military psychiatry clinic.Milit Med,163,58-60.
13. Jill S,Marlys S,Sue M,Sharon K(2007).Using telephone reminders to increase attendance at psychiatric appointments: finding of a pilot study in rural Appalachia.Psychiatr Serv,58,872-875.
14. Landy FS,Mary CM,Mark FW(1993).Missed psychiatric appointments: who returns and who stays away.Am J Psychiatry,150,801-805.
15. Michael G,Philip L,Mark C,Andrew CL,Mark O,Laura P(1996).Predictors of missed appointments for psychiatric consultations in a primary care clinic.Psychiatr Serv,47,848-852.
16. Mohan IK,Venugopal D(2000).Depression: psychosocial basis.J Indian Med Assoc,98,224-231.
17. Nicola B,Ciaran R,Gill L(2006).Adherence to treatment in mood disorders.Curr Opin Psychiatry,19,44-49.
18. Nurnberg HG(2008).An evidence-based review updating the various treatment and management approaches to serotonin reuptake inhibitor-associated sexual dysfunction.Drugs of Today,44,147-168.
19. Papakostas GI(2008).Tolerability of modem antidepressants.J Clin Psychiatry,69,8-13.
20. Rahme E,Dasgupta K,Tureeki G,Nedjar H,Galbaud du Fort G(2008).Risks of suicide and poisoning among elderly patients prescribed selective serotonin reuptake inhibitors: a retrospective cohort study.J Clin Psychiatry,69,349-357.
21. Sun, Shawn XL,Gordon GC,Dale B(2007).Review and analysis of hospitalization costs associated with antipsychotic non-adherence in the treatment of schizophrenia in the United States.Curr Med Res Opin,23,2305-2312.
22. Tay SE(2007).Compliance therapy: an intervention to improve inpatients' attitudes toward treatment.J Psychosoc Nurs Ment Health Serv,45,29-37.
23. Trivedi MH,Hollander E,Nutt D,Blier P(2008).Clinical evidence and potential neurobiological underpinnings of unresolved symptoms of depression.J Clin Psychiatry,69,246-258.