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
en 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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Aceptación de la Atención de Salud
/
Hemofilia A
Tipo de estudio:
Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Límite:
Child, preschool
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Female
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Humans
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Infant
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Male
/
Newborn
País/Región como asunto:
America do norte
Idioma:
En
Revista:
Haemophilia
Asunto de la revista:
HEMATOLOGIA
Año:
2018
Tipo del documento:
Article
País de afiliación:
Estados Unidos