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A cross‐sectional study of non‐attendance among patients at a US hemophilia treatment center 2010‐2014
Author(s) -
Barry V.,
Steffens C.,
Mattis S.,
Sidonio R. F.,
Tran D. Q.,
Kempton C. L.
Publication year - 2018
Publication title -
haemophilia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.213
H-Index - 92
eISSN - 1365-2516
pISSN - 1351-8216
DOI - 10.1111/hae.13553
Subject(s) - medicine , cross sectional study , attendance , center (category theory) , pediatrics , family medicine , pathology , economics , economic growth , chemistry , crystallography
Among patients with chronic disease, non‐attendance at scheduled healthcare visits is associated with poor outcomes. The impact of non‐attendance among patients with bleeding disorders is unknown. Methods Scheduling and medical record data over a 5‐year period for all individuals with at least one scheduled appointment during 2010‐2014 at a US Hemophilia Treatment Center ( HTC ) were analysed. Non‐attendance rates were calculated as the number of non‐attended visits divided by the number of years as a patient during the time period. Consistent non‐attenders were patients who did not attend more than one scheduled appointment per person‐year on average. Logistic regression determined characteristics associated with consistent non‐attendance and Poisson regression estimated adjusted incidence rate ratios ( aIRR s) describing associations between non‐attendance and emergency department ( ED ) visits and hospitalizations. Results There were 8028 appointments scheduled for 950 individuals; 12% were not attended. Consistent non‐attenders (n = 62; 7% of the HTC patient population) accounted for over one‐third of non‐attended appointments and over one‐quarter of hospitalizations. Characteristics associated with consistent non‐attendance included public health insurance and black race. Higher non‐attendance rates were associated with more ED visits ( aIRR 1.78; 95% CI : 1.37‐2.30) and hospitalizations ( aIRR 2.73; 95% CI : 2.18‐3.42). Consistent non‐attenders had more ED visits ( aIRR 2.49; 95% CI : 1.56‐3.96) and hospitalizations ( aIRR 4.73; 95% CI : 2.96‐7.57) compared with patients who never missed appointments. Conclusions Frequent non‐attendance identified a small but at‐risk population. Interventions to improve disease management that target them may have an impact on health outcomes and healthcare utilization.