由于缺乏合格人员和设备的有限可用性,胃肠道(GI)内窥镜检查是一种有限的健康资源。因此,不遵守内窥镜检查预约会浪费医疗保健资源,并可能损害胃肠道疾病的早期检测和治疗。我们的目的是确定影响不参加胃肠道内窥镜检查的预定预约的因素,从而改善胃肠道医疗结果。
这是一项在三级医院胃肠病内镜部门进行的单中心回顾性队列研究,COVID-19大流行开始前12个月和后12个月。我们使用多元逻辑回归分析来确定与预定约会不出勤相关的变量。
总的来说,分析了5,938个约会,缺勤率为18.3%(1088)。大流行期间的缺席率显著下降(22.6%与11.6%,p<0.001)。多变量回归分析确定没有深度镇静(OR:3.253,95%CI[2.386-4.435];p<0.001),来自胃肠病学家以外的医生的转诊(OR:1.891,95%CI[1.630-2.193];p<0.001),较长的提前期(OR:1.006,95%CI[1.004-1.008];p<0.001),和女性性别(OR:1.187,95%CI[1.033-1.363];p=0.015)与预约不出勤相关。
女性患者,那些在没有深度镇静的情况下接受内窥镜手术的人,那些由胃肠病学家以外的医生推荐的,和更长的准备时间不太可能坚持任命。预防措施应针对具有一种或多种这些危险因素的患者,以及在COVID-19大流行期间计划进行筛查的人群。
Gastrointestinal (GI) endoscopy is a limited health resource because of a scarcity of qualified personnel and limited availability of equipment. Non-adherence to endoscopy appointments therefore wastes healthcare resources and may compromise the early detection and treatment of GI diseases. We aimed to identify factors affecting non-attendance at scheduled appointments for GI endoscopy and thus improve GI healthcare outcomes.
This was a single-center retrospective cohort study performed at a tertiary hospital gastroenterology endoscopy unit, 12 months before and 12 months after the start of the COVID-19 pandemic. We used multiple logistic regression analysis to identify variables associated with non-attendance at scheduled appointments.
Overall, 5,938 appointments were analyzed, and the non-attendance rate was 18.3% (1,088). The non-attendance rate fell significantly during the pandemic (22.6% vs. 11.6%, p < 0.001). Multivariable regression analysis identified the absence of deep sedation (OR: 3.253, 95% CI [2.386-4.435]; p < 0.001), a referral from a physician other than a gastroenterologist (OR: 1.891, 95% CI [1.630-2.193]; p < 0.001), a longer lead time (OR: 1.006, 95% CI [1.004-1.008]; p < 0.001), and female gender (OR: 1.187, 95% CI [1.033-1.363]; p = 0.015) as associated with appointment non-attendance.
Female patients, those undergoing endoscopic procedures without deep sedation, those referred by physicians other than gastroenterologists, and with longer lead time were less likely to adhere to appointments. Precautions should be directed at patients with one or more of these risk factors, and for those scheduled for screening procedures during the COVID-19 pandemic.