乳腺影像预约失约原因调查：安全网医疗实践的结果
该质量改进项目调查了165名曾失约乳腺影像检查并重新预约的患者，通过问卷了解失约原因及改进建议。最常见原因为遗忘或不知晓预约（35%）、交通问题（20%）和经济困难（19%）；建议包括加强预约提醒（29%）、资金或保险援助（12%）和交通支持（8%）。优化患者自选提醒方式并解决经济交通障碍可能提高依从性。
要点
- 失约主因是遗忘或不知晓预约、交通困难和经济困难。
- 患者建议加强提醒、提供资金援助和交通支持。
- 短信是单选提醒方式中最受青睐的类型。
诊断标准与关键数值
- 失约原因：不知晓或遗忘预约占35%（57/165），交通问题占20%（33/165），经济困难占19%（31/165）。
- 改进建议：加强预约提醒占29%（48/165），资金或保险援助占12%（20/165），交通支持占8%（13/165）。
- 提醒偏好：63%（104/165）患者仅选择一种提醒方式，其中短信最常被选择（38%，39/104）。
- 不同收入水平与失约原因相关，社会人口学与提醒方式偏好无关联。
临床应用与阅片要点
- 阅片外可关注患者预约提醒方式偏好，建议采用短信等患者自选提醒以减少失约。
- 识别经济困难和交通障碍患者，联动资源提供支持以改善检查依从性。
局限性
- 单中心质量改进项目，样本量有限（165名 responders），结果外推需谨慎。
- 失约原因和自我报告建议可能存在回忆偏倚和社会期望偏倚。
以上解读依据论文摘要（全文未开放获取或许可不允许翻译转载）。
英文原文（摘要）· 点击展开
RATIONALE AND OBJECTIVES: Missed appointments in breast imaging delay care and may negatively affect outcomes. This study aimed to identify factors associated with missed breast imaging appointments and understand patient-reported reasons for no-shows to inform targeted interventions in a medically underserved population.
MATERIALS AND METHODS: This quality improvement project, designated as non-regulated research, surveyed 165 patients who had previously missed a breast imaging appointment and were rescheduled. Participants completed a questionnaire in-person or by telephone regarding reasons for missing appointments and suggestions to improve attendance. Demographic information was collected. Associations between sociodemographics and reasons for missed appointments and reminder types were analyzed.
RESULTS: Of 260 patients identified for the survey, 165 (63%) responded. The most frequent reasons for missed appointments were lack of awareness or forgotten appointments (35%, 57/165), financial hardship (19%, 31/165), and transportation issues (20%, 33/165). Suggested improvements included enhanced appointment reminders (29%, 48/165), funding or insurance assistance (12%, 20/165), and transportation support (8%, 13/165). Most patients selected only one type of reminder (63%, 104/165), with text messaging the most selected for those choosing a single reminder type (38%, 39/104). Differences in responses for missed appointments were associated with different income levels, while no association of sociodemographics with preferred reminder type was seen.
CONCLUSION: Reducing missed breast imaging appointments is essential to improving access to timely care, particularly in underserved populations. Optimizing appointment reminders, especially through patient-selected reminder types and addressing financial and transportation barriers may improve adherence and promote equitable access to breast imaging services.
引用
- Kinchen C, Matheus P, Omar L, et al. Missed Care Appointments: Survey Results From a Safety-Net Breast Imaging Practice. Acad Radiol. 2026. PMID: 42062109. doi:10.1016/j.acra.2026.04.008
供执业医师工作参考，不替代临床判断；数值与分级以指南原文为准。