利用自我调度提高乳房x线摄影筛查完成率

IF 4 3区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Journal of the American College of Radiology Pub Date : 2025-03-01 DOI:10.1016/j.jacr.2024.10.007

Gillean Cortes DO , Wen-Pin Chen MS , Ziogas Aryagus PhD , Ali Rashidi MD , Irene Tsai MD , Gelareh Sadigh MD

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引用次数: 0

摘要

目的：自我调度有可能提高便利性和患者参与度。我们比较了实施在线自我调度系统前后使用自我调度与传统调度的患者的门诊筛查乳房x光检查完成率。2021年2月，Epic MyChart在线门户网站在机构层面实施了自我安排流程，允许患者自行安排乳房x光筛查。本回顾性队列研究纳入了2017年10月1日至2023年6月30日期间在三级医疗机构安排门诊筛查乳房x光检查的18岁及以上女性，在实施前阶段至少有一次就诊，在实施后阶段至少有一次就诊，并且在实施后阶段仅使用一种调度方法（自我调度或传统调度）。进行了差异性分析，比较了在实施后使用传统和自我安排的患者的筛查乳房x线检查完成率。结果7203例患者共进行乳房x线筛查29893次，平均年龄58.1岁；70.0%白人，18.2%亚裔，1.8%黑人，19.5%西班牙裔)。实施前乳房x线检查总体完成率为78.9%，实施后完成率为79.8%。使用差中差估计，自调度队列的完成率比传统调度高8.4个百分点（95%置信区间，5.2-11.6）。自计划队列的乳房x线筛查完成率从实施后到实施前的变化为+8.5个百分点（实施后为88.1%，实施前为79.6%），传统计划队列为+0.1个百分点（实施后为80.8%，实施前为80.7%）。结论与传统计划相比，自我计划可提高实施后乳房x线检查的完成率。

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Using Self-Scheduling to Improve Screening Mammography Completion Rates

Purpose

Self-scheduling has the potential to enhance convenience and patient engagement. We compared outpatient screening mammography completion rates before and after implementing an online self-scheduling system between patients who use self-scheduling versus traditional scheduling.

Methods

In February 2021, a self-scheduling process was implemented at an institutional level through the Epic MyChart online portal, allowing patients to self-schedule screening mammography. This retrospective cohort study included women aged 18 and over who scheduled outpatient screening mammography in a tertiary health care facility from October 1, 2017, to June 30, 2023, had at least one encounter during the pre-implementation phase and one encounter during the postimplementation period, and only used one scheduling method (self-scheduling or traditional scheduling) in the postimplementation period. Difference-in-difference analyses were conducted to compare screening mammography completion rates between patients who used traditional versus self-scheduling in the postimplementation period.

Results

In all, 29,893 screening mammography were scheduled by 7,203 patients (mean age: 58.1 years; 70.0% White, 18.2% Asian, 1.8% Black, and 19.5% Hispanic). The overall mammography completion rate in pre-implementation period was 78.9% and increased to 79.8% in the postimplementation period. Using difference-in-difference estimator, the completion rates in the self-scheduling cohort was 8.4 percentage point (95% confidence interval, 5.2-11.6) higher than traditional scheduling. The change in screening mammography completion rate from the postimplementation to pre-implementation period was +8.5 percentage point (88.1% postimplementation versus 79.6% pre-implementation) for the self-scheduling cohort and +0.1 percentage point (80.8% postimplementation versus 80.7% pre-implementation) for the traditional scheduling cohort.

Conclusion

Self-scheduling was linked to increased screening mammography completion rates postimplementation when compared to traditional scheduling.

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来源期刊

Journal of the American College of Radiology RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING-

CiteScore

6.30

自引率

8.90%

发文量

312

审稿时长

34 days

期刊介绍： The official journal of the American College of Radiology, JACR informs its readers of timely, pertinent, and important topics affecting the practice of diagnostic radiologists, interventional radiologists, medical physicists, and radiation oncologists. In so doing, JACR improves their practices and helps optimize their role in the health care system. By providing a forum for informative, well-written articles on health policy, clinical practice, practice management, data science, and education, JACR engages readers in a dialogue that ultimately benefits patient care.