A cross-sectional study of non-attendance among patients at a US hemophilia treatment center 2010-2014.
Haemophilia
; 24(6): 902-910, 2018 Nov.
Article
in En
| MEDLINE
| ID: mdl-29989321
ABSTRACT
INTRODUCTION:
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 (aIRRs) 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.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Patient Acceptance of Health Care
/
Hemophilia A
Type of study:
Observational_studies
/
Prevalence_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Child, preschool
/
Female
/
Humans
/
Infant
/
Male
/
Newborn
Country/Region as subject:
America do norte
Language:
En
Journal:
Haemophilia
Journal subject:
HEMATOLOGIA
Year:
2018
Type:
Article
Affiliation country:
United States