How Can New Technologies Help Reduce Absenteeism in Pediatric Consultation?

Abstract

Objective: To identify the most effective form of contact, as a possible intervention to reduce absenteeism in consultations of children with suspected or confirmed pulmonary tuberculosis. Methods: A randomized clinical trial was conducted with prospective data collection, between March 2017 and February 2018. Patients were randomized into three groups to be reminded about the appointment: telephone contact, SMS or WhatsApp, or no intervention. A convenience sample was obtained, with a significance level of 5%. Results: 78 children were included, with a median age of four years old (zero to 14); 59.0% of them were in treatment for a latent infection and 6.4% had active tuberculosis. Among the 78 children, 74.4% lived in Curitiba (Sourhern Brazil); 62.8% lived with both parents; 38.5% of the parents had formal employment and 47.4% of the mothers were housewives; 50.8% of the fathers and 55.7% of the mothers had more than nine years of schooling. In 78.2% of the families, per capita income was up to 0.5 minimum wages; 27.3% were enrolled in social programs; 28.2% lived in homes provided by the government. There was a total of 238 interventions made: 85 (35.7%) by telephone contact, 78 (32.8%) by text message (WhatsApp was 97.2% of these) and 75 (31.5%) had no further contact. There was no statistical difference among the sociodemographic and cultural characteristics studied. The absenteeism rate was 24.0% and the abandonment rate was 16.7%. Giving a reminder to the patient’s guardian prior to the consultation, regardless of the intervention (p=0.021) and specifically by WhatsApp message (p=0.032) was associated with no absenteeism, though it was not associated with abandonment of the treatment. Conclusions: Using new tools, such as WhatsApp, to remind guardians of appointments reduces absenteeism. Consequently, it may lead to a reduction in abandoning treatment and it may improvetreatment outcome of children with a tuberculosis infection or disease.

Fatores determinantes do absenteísmo de pacientes às consultas agendadas na Unidade Básica de Saúde Laranjeiras, Marabá, Pará

“…Deve-se ressaltar os malefícios que os registros incorretos das marcações de consultas podem repercutir para a gestão da UBS. Isso porque impede com que os pacientes sejam contactados, o que poderia ser uma forma de diminuir o absenteísmo (Bueno et al, 2020). No caso do presente estudo, das 92 ligações bem sucedidas, 20,6% (n = 19) foram excluídas por erros de registros.…”

“…Ainda neste motivo, destacou-se que alguns pacientes não se encontravam na cidade ou estavam comprometidos com outras atividades. Nesses casos, seria interessante fazer contato com os pacientes um dia antes para confirmar sua presença, e este contato poderia ser feito por mensageiros online, por exemplo (Bueno et al, 2020).…”

What do we know about no‐show behavior? A systematic, interdisciplinary literature review

“…In particular, we note a consistent role of the lead time, that is, the time span between the scheduling of the appointment and the subsequent appointment, indicating that an increase in the lead time is associated with an increase in NSB (e.g., Guzek et al., 2015). In fact, most previous survey research has frequently found that one potential explanation for this relationship might be simple forgetfulness (e.g., Bueno et al., 2020), thus applying different variations of a reminder to reduce NSB. Naturally, an alternative would be to reduce lead times.…”

“…Although the continuously growing body of literature on NSB has been reviewed before (e.g., Stubbs et al., 2012), most such previous attempts were neither interdisciplinary nor systematic, sometimes lacking both completeness and thoroughness (c.f., Tranfield et al., 2003). For instance, while authors have increasingly summarized the literature on NSB in healthcare subspecialties such as Endoscopy (e.g., Lam et al., 2021), Pediatric (e.g., Bueno et al., 2020) or Radiology (e.g., Mieloszyk et al., 2019), to the best of our knowledge, there as yet only exists one review synthesizing the literature on the antecedents of such behavior across such subspecialties (Dantas et al., 2018), thus providing a more holistic picture on the underlying mechanisms in the healthcare industry. However, it remains largely unclear whether these initial findings are robust across different industries, and, consequently, whether, and if so to what degree, service firms might be able to learn from each other across disciplines.…”