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Introdução: A não comparência dos utentes a consultas externas constitui um obstáculo persistente à eficiência dos serviços de saúde, comprometendo um acesso equitativo e atempado a cuidados de saúde. Este problema revela-se particularmente crítico na Oftalmologia, uma das especialidades médicas com maior pressão assistencial. Objetivo: Determinar o efeito da não comparência dos utentes na eficiência do Serviço de Oftalmologia da Unidade Local de Saúde do Alentejo Central (ULSAC). Metodologia: A dissertação foi desenvolvida em duas fases: (i) uma revisão de âmbito, intitulada “O Impacto dos Sistemas de Lembrete na Redução da Não Comparência dos Utentes às Consultas Externas”, com base na metodologia do Joanna Briggs Institute, utilizando termos como no-show patients, non-attendance e reminder systems, e seguindo os itens do PRISMA-ScR; incluíram-se apenas estudos originais focados em sistemas de lembrete em consultas externas. (ii) um estudo observacional retrospetivo, baseado nos registos eletrónicos de agendamentos de consultas médicas e meios complementares de diagnóstico e terapêutica (MCDT) do serviço de Oftalmologia da ULSAC, em 2023. Foram registados 44.948 agendamentos, dos quais 37.487 correspondiam a agendamentos programados. Resultados: A taxa de não comparência (Tx.NC) foi de 8% para consultas médicas e 13% para MCDT. As consultas de primeira vez revelaram maior vulnerabilidade à não comparência e as subespecialidades de retinopatia da prematuridade e oftalmologia pediátrica/estrabismo registaram as Tx.NC mais elevadas. Entre os MCDT, destacaram-se as avaliações de ortóptica e respetivas sessões de tratamento. As ausências dos utentes afetaram negativamente o seu percurso clínico e contribuíram para desequilíbrios no serviço e na carga de trabalho dos profissionais. A revisão de âmbito evidenciou que os sistemas de lembrete constituem uma solução efetiva neste contexto e podem reduzir entre 40 e 50% as Tx.NC, o que poderia ser um bom ponto de partida para mitigar as não comparências no serviço. Conclusão: Esta dissertação demonstra que a não comparência dos utentes compromete significativamente a eficiência do Serviço de Oftalmologia da ULSAC, resultando num elevado desperdício de recursos. Sugere-se a implementação de estratégias integradas, como a adoção de um sistema de lembrete, educação do utente e otimização dos percursos assistencial e administrativo, de modo a promover a adesão às consultas e aos exames e melhorar o desempenho do serviço.
ABSTRACT Introduction: Patient non-attendance at outpatient appointments represents a persistent obstacle to the efficiency of healthcare services, reducing equitable and timely access to medical care. This issue is particularly critical in Ophthalmology, one of the medical specialties with the highest demand. Objective: To determine the effect of patient non-attendance on the efficiency of the Ophthalmology Department at the Local Health Unit of Central Alentejo (ULSAC). Methodology: The dissertation was developed in two phases: (i) A scoping review, entitled "The Impact of Reminder Systems on Reducing Patient Non-Attendance at Outpatient Appointments", based on the Joanna Briggs Institute methodology, using terms such as no-show patients, non-attendance, and reminder systems, and following the PRISMA-ScR guidelines. Only original studies focusing on reminder systems in outpatient consultations were included. (ii) A retrospective observational study based on electronic records of scheduled medical consultations and diagnostic and therapeutic procedures (DTPs) from the Ophthalmology Department of ULSAC in 2023. A total of 44,948 appointments were recorded, of which 37,487 were scheduled consultations. Results: The non-attendance rate (NAR) was 8% for medical consultations and 13% for CDTPs. New patient appointments were more vulnerable to non-attendance, and the subspecialties of retinopathy of prematurity and pediatric ophthalmology/strabismus showed the highest NARs. Among DTPs, orthoptic tests and corresponding treatment sessions stood out. Patient absences negatively impacted their clinical pathway and contributed to service disturbance and increased workload for professionals. The scoping review highlighted that reminder systems are an effective solution in this context and can reduce NARs by 40% to 50%, which could serve as a good starting point to mitigate non-attendance in the department. Conclusion: This dissertation demonstrates that patient non-attendance significantly compromises the efficiency of the Ophthalmology Department at ULSAC, resulting in substantial resource waste. The implementation of integrated strategies is recommended, such as the adoption of a reminder system, patient education, and optimization of care and administrative pathways, to promote patient compliance and improve service performance.
ABSTRACT Introduction: Patient non-attendance at outpatient appointments represents a persistent obstacle to the efficiency of healthcare services, reducing equitable and timely access to medical care. This issue is particularly critical in Ophthalmology, one of the medical specialties with the highest demand. Objective: To determine the effect of patient non-attendance on the efficiency of the Ophthalmology Department at the Local Health Unit of Central Alentejo (ULSAC). Methodology: The dissertation was developed in two phases: (i) A scoping review, entitled "The Impact of Reminder Systems on Reducing Patient Non-Attendance at Outpatient Appointments", based on the Joanna Briggs Institute methodology, using terms such as no-show patients, non-attendance, and reminder systems, and following the PRISMA-ScR guidelines. Only original studies focusing on reminder systems in outpatient consultations were included. (ii) A retrospective observational study based on electronic records of scheduled medical consultations and diagnostic and therapeutic procedures (DTPs) from the Ophthalmology Department of ULSAC in 2023. A total of 44,948 appointments were recorded, of which 37,487 were scheduled consultations. Results: The non-attendance rate (NAR) was 8% for medical consultations and 13% for CDTPs. New patient appointments were more vulnerable to non-attendance, and the subspecialties of retinopathy of prematurity and pediatric ophthalmology/strabismus showed the highest NARs. Among DTPs, orthoptic tests and corresponding treatment sessions stood out. Patient absences negatively impacted their clinical pathway and contributed to service disturbance and increased workload for professionals. The scoping review highlighted that reminder systems are an effective solution in this context and can reduce NARs by 40% to 50%, which could serve as a good starting point to mitigate non-attendance in the department. Conclusion: This dissertation demonstrates that patient non-attendance significantly compromises the efficiency of the Ophthalmology Department at ULSAC, resulting in substantial resource waste. The implementation of integrated strategies is recommended, such as the adoption of a reminder system, patient education, and optimization of care and administrative pathways, to promote patient compliance and improve service performance.
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Gestão em saúde Não comparência Consulta externa Eficiência Oftalmologia Sistema de lembrete Serviço de saúde Healthcare management Non-attendance Outpatient consultation Efficiency Ophthalmology Reminder system Healthcare service