Discovering patterns in outpatient neurology appointments using state sequence analysis.
Neurology
Outpatient appointments
Routinely collected data
State sequence analysis
Journal
BMC health services research
ISSN: 1472-6963
Titre abrégé: BMC Health Serv Res
Pays: England
ID NLM: 101088677
Informations de publication
Date de publication:
06 Nov 2023
06 Nov 2023
Historique:
received:
27
01
2023
accepted:
26
10
2023
medline:
7
11
2023
pubmed:
6
11
2023
entrez:
5
11
2023
Statut:
epublish
Résumé
Outpatient services in the UK, and in particular outpatient neurology services, are under considerable pressure with an ever-increasing gap between capacity and demand. To improve services, we first need to understand the current situation. This study aims to explore the patterns of appointment type seen in outpatient neurology, in order to identify potential opportunities for change. We use State Sequence Analysis (SSA) on routinely collected data from a single neurology outpatient clinic. SSA is an exploratory methodology which allows patterns within sequences of appointments to be discovered. We analyse sequences of appointments for the 18 months following a new appointment. Using SSA we create groups of similar appointment sequence patterns, and then analyse these clusters to determine if there are particular sequences common to different diagnostic categories. Of 1315 patients 887 patients had only one appointment. Among the 428 patients who had more than one appointment a 6 monthly cycle of appointments was apparent. SSA revealed that there were 11 distinct clusters of appointment sequence patterns. Further analysis showed that there are 3 diagnosis categories which have significant influence over which cluster a patient falls into: seizure/epilepsy, movement disorders, and headache. Neurology outpatient appointment sequences show great diversity, but there are some patterns which are common to specific diagnostic categories. Information about these common patterns could be used to inform the structure of future outpatient appointments.
Sections du résumé
BACKGROUND
BACKGROUND
Outpatient services in the UK, and in particular outpatient neurology services, are under considerable pressure with an ever-increasing gap between capacity and demand. To improve services, we first need to understand the current situation. This study aims to explore the patterns of appointment type seen in outpatient neurology, in order to identify potential opportunities for change.
METHODS
METHODS
We use State Sequence Analysis (SSA) on routinely collected data from a single neurology outpatient clinic. SSA is an exploratory methodology which allows patterns within sequences of appointments to be discovered. We analyse sequences of appointments for the 18 months following a new appointment. Using SSA we create groups of similar appointment sequence patterns, and then analyse these clusters to determine if there are particular sequences common to different diagnostic categories.
RESULTS
RESULTS
Of 1315 patients 887 patients had only one appointment. Among the 428 patients who had more than one appointment a 6 monthly cycle of appointments was apparent. SSA revealed that there were 11 distinct clusters of appointment sequence patterns. Further analysis showed that there are 3 diagnosis categories which have significant influence over which cluster a patient falls into: seizure/epilepsy, movement disorders, and headache.
CONCLUSIONS
CONCLUSIONS
Neurology outpatient appointment sequences show great diversity, but there are some patterns which are common to specific diagnostic categories. Information about these common patterns could be used to inform the structure of future outpatient appointments.
Identifiants
pubmed: 37926834
doi: 10.1186/s12913-023-10218-y
pii: 10.1186/s12913-023-10218-y
pmc: PMC10626691
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1208Subventions
Organisme : EPSRC
ID : EP/R513076/1
Informations de copyright
© 2023. The Author(s).
Références
J Neurol. 2022 Dec;269(12):6211-6221
pubmed: 35353231
Stat Methods Med Res. 2019 Jun;28(6):1731-1740
pubmed: 29742976
Stat Methods Med Res. 2019 Jun;28(6):1651-1663
pubmed: 29717944
BMC Health Serv Res. 2022 Jan 31;22(1):131
pubmed: 35101054
Soc Sci Res. 2022 Sep;107:102772
pubmed: 36058612
Acta Psychiatr Scand. 2022 May;145(5):469-480
pubmed: 35152415
Schizophrenia (Heidelb). 2022 May 19;8(1):52
pubmed: 35854023
Chest. 2023 Apr;163(4):826-842
pubmed: 36257472
Int J Environ Res Public Health. 2021 Dec 20;18(24):
pubmed: 34949007
Rev Neurol (Paris). 2021 Dec;177(10):1250-1261
pubmed: 34253346
Mult Scler. 2022 Feb;28(2):309-322
pubmed: 34048293
BMC Health Serv Res. 2020 Mar 6;20(1):177
pubmed: 32143702
BMC Health Serv Res. 2015 May 15;15:200
pubmed: 25976089