Factors Associated With Nonattendance at Scheduled Outpatient Appointments in a University General Hospital (AU1)

Our objectives were to estimate the prevalence of nonattendance at outpatient offices, to identify the characteristics of appointments for which nonattendance was more likely to occur, and to generate a predictive model that could be applied to each appointment to estimate the probability of nonattendance.

Study Overview

• Status: Completed
• Conditions: Appointments and Schedules; Outpatient Clinics, Hospital/Economics

Detailed Description

Nonattendance at scheduled appointments at outpatient clinics is a common problem in general medical practice, representing a significant cost to the health care system, and resulting in disruption of daily work planning.Nonattendance at medical appointments has consequences not only for doctors (as it requires a greater use of resources and time), but also for patients, because there may be deterioration in the quality of care, and dissatisfaction associated with delays in obtaining a new appointment.

Previous studies have reported that nonattendance at scheduled appointments is most frequently associated with those patients attending follow-up appointments, generally those assigned to another professional, those with appointments on Fridays, and those with appointments assigned 1 - 2 weeks in advance. Nonattendance was also associated with younger patient age, greater psychological problems, and lower socioeconomic status.Furthermore, in patients with chronic diseases, the nonattendance rate was also reported to be lower. Clinical patient characteristics can be important predictors of nonattendance, but they required high quality electronic health records to predict nonattendance accurately In the United States and Europe, the nonattendance rate is estimated to be between 6.5%-55%; there is little evidence regarding nonattendance in Latin America. Many studies have described the prevalence and impact of nonattendance at scheduled medical appointments, and possible strategies to decrease the nonattendance rate. However, few studies have utilized the characteristics associated with nonattendance for building predictive models, which might better identify those patients who may not attend a scheduled appointment

• Study Type: Observational
• Enrollment (Actual): 10000

Contacts and Locations

Study Locations

• Argentina
  • Buenos Aires
    • Capital Federal, Buenos Aires, Argentina, C1199ABD
      • Hospital Italiano de Buenos Aires

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 18 years and older (Adult, Older Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

• Sampling Method: Probability Sample

Study Population

We included all requested appointments (random consecutive sampling) between 2012 and 2013 (24 month). The sample was randomized to allocate a generation cohort (two-thirds of the sample) and a validation cohort (one third of the sample).

Description

Inclusion Criteria:

• Over 17 years.
• Adults who attended, did not attend and cancelled a scheduled appointment at the Outpatient care system at the Italian Hospital of Buenos Aires (HIBA)

Exclusion Criteria:

• The refusal to register or to the informed consent process.

Study Plan

How is the study designed?

Number of groups / cohorts

1

Cohorts and Interventions

Group / Cohort
Retrospective Cohort; Adult patients who had scheduled an appointment for outpatient primary care. Patients were divided into two groups, including those who attended their scheduled appointment and those who missed it.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Prevalence of non attendance, attendance and cancellation	Characterize, describe and compare the clinical and administrative characteristics of outpatients who didn't attend, attended and cancelled an appointment in internal medicine/primary health care, clinical subspecialties and surgical specialties.	Cohort study of 24 month

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Clinical and administrative characteristics	Characterize, describe and compare the clinical and administrative characteristics of outpatients who didn't attend, attended and cancelled an appointment in internal medicine/primary health care, clinical subspecialties and surgical specialties.	Cohort study of 24 month

Collaborators and Investigators

• Sponsor: Hospital Italiano de Buenos Aires

Study record dates

Study Major Dates

• Study Start: May 1, 2014
• Primary Completion (Actual): September 1, 2014
• Study Completion (Actual): December 1, 2014

Study Registration Dates

• First Submitted: April 6, 2014
• First Submitted That Met QC Criteria: April 6, 2014
• First Posted (Estimate): April 9, 2014

Study Record Updates

• Last Update Posted (Estimate): March 24, 2015
• Last Update Submitted That Met QC Criteria: March 19, 2015
• Last Verified: March 1, 2015

More Information

Terms related to this study

• Keywords: Appointments and Schedules; Outpatient Clinics, Hospital/economics
• Other Study ID Numbers: 2262