Factors Associated with Miss-appointment of Cancer Patients Treated by Radiotherapy —Using One Medical Center as Example

• Main Authors: Kuo- Jung Juan, 阮國榮
• Other Authors: Yong-yuan Chang
• Format: Others
• Language: zh-TW
• Published: 2007
• Online Access: http://ndltd.ncl.edu.tw/handle/04978158812902604836

碩士 === 高雄醫學大學 === 醫務管理學研究所碩士在職專班 === 95 === Objective: For some reason, cancer patients treated by radiotherapy (RT) experienced miss-appointment, thus reducing the utility of treatment machines and affecting the appointment schedule for other patients. To optimize the treatment utility and medical management, we investigated the factors associated with patient miss-appointment during RT. Methods: We prospectively and consecutively enrolled 505 cancer patients treated at the department of radiation oncology at a medical center from July 1 to December 31 in 2007. The questionnaire concerning the reasons of miss-appointment was documented and the sociodemographic and cancer-related data of patients were reviewed. Logistic regression model was used for multivariate analysis. Results: Three hundred thirty six patients had no experience of miss-appointment. There were 169 cases experiencing at least one miss-appointment. The total miss-appointment number was 330, with a miss-appointment rate of 4.58%. Concerning the sociodemographic and cancer-related factors, we found patients with annual income below 10 million NTD (aOR=9.690, 95% CI=1.263-74.371), and those treated with RT dose below 3000 cGy experienced more miss-appointment (aOR=2.148, 95% CI=1.295-3.564) compared with the counterparts, respectively. Feeling ill was the most common (48.5%) reason of miss-appointment. It was found that in-patients (aOR=2.378, 95%=1.429-3.958), and those treated with RT dose below 3000 cGy experienced more miss-appointment due to feeling-ill (aOR=2.148, 95% CI=1.295-3.564) compared with the counterparts, respectively. Discussion & Suggestion: To the best of our knowledge, the investigation of miss-appointment for cancer patients treated by RT was seldom reported in the literature. Our findings that patients with higher annual income or higher socioeconomic level experienced less miss-appointment were compatible with other reports for non-cancer outpatients. On the contrast, RT dose and in-patients or not were also found to be significant factors associated with patient miss-appointment. However, the reasons of miss-appointment, such as feeling ill, being busy at home, poor communication, and traffic problems, for cancer patients under RT were concordant with those for non-cancer outpatients. Our suggestions are as follows: 1.To reduce the miss-appointment rate by telephone communication in advance, etc. 2.To over-appoint the patient number to maximize the machine utility. 3.To control the miss-appointment persistently to improve the efficiency and management of hospital.