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- 저자 : ( Analia Judith Baum ) (검색결과 1 건)
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( Diego Hernan Giunta ),( Analia Judith Baum ),( Bruno Rafael Boietti ),( Nora Angelicafuentes ),( Carolina Gabay ),( Fernan Gonzalez Bernaldo De Quiros ),( Maria Florencia Grande Ratti ),( Daniel Rob 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Introduction: Nonattendance to scheduled outpatient appointments (SOA) produces ineffi ciency and discontinuity in care, although associated impact on mortality is unknown. Objetive: Evaluate association between SOA in primary care with emergency assessments (EA), emergency hospitalization (EH) and mortality (M) throughout a year. Methods: Retrospective cohort of adults affi liated to Hospital Italiano, with at least one SOA during 2012. We included all patients beginning from the last SOA of 2012 and followed them throughout a year, describing the events of EA, EH and M. We measured the number of SOA and the nonattendance proportion at the previous year before inclusion to the cohort. We used a Cox proportional hazards regression model, to estimate crude and adjusted Hazard Ratios (HR) and 95% confi dence interval. Results: 117327 patients were included, with a median age of 59 years (IQR:34), with a female frequency of 63. 3% (74300). Median of SOA was 8 appointments (IQR 9), the median of the nonattendance proportion of each patient was 28. 6% (IQR 39). 26% of patients had a proportion of nonattendance of 50% or more. EA was 13. 5% (15858); EH was of 3% (3551); and mortality was 1. 6% (1853) during follow up. Crude HR for each 10% increase in nonattendance proportion was 1. 031 (95%, IC:1. 025- 1. 037, p<0, 001) for EA; 1, 012 (95%, IC:1-1. 025, p=0. 051) for EH; and 1. 028 (95%, IC:1. 011-1, 045, p<0, 001) for M. Adjusted HR (by sex, age, diabetes, hypertension, cancer and coronary disease) for each 10% increment in nonattendance proportion was 1. 010 (95%, IC:1. 004-1. 017, p<0, 001);1. 099 (95%, IC:1. 084-1. 113, p<0, 001); and 1. 125 (IC95% 1, 105-1, 145, p<0, 001) for EA, EF and M respectively. Conclusions: Even though the nonattendance proportion effect on EA, EH and M is moderate, it could be relevant as a prognostic factor in high risk patients subgroups.
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