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Uncontrolled diabetes predictor for missed appointments
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Nonattendance or same-day cancellations for future scheduled endocrinology appointments may be predicted by a previous history of nonattendance and uncontrolled diabetes, study data show.
“The problem of the nonattendance to the endocrine clinic has to be assessed in a systematic way so we are able to adjust,” Wael Emad Eid, MD, FACP, FACE, CDE, endocrinologist at St. Elizabeth Healthcare in Covington, Kentucky, told Endocrine Today. “This is especially important given the concerns with current access to endocrine care with the projected national shortage of endocrinology work force.”
Eid and colleagues conducted a retrospective, records-based, cross-sectional study using data from 9,305 electronic medical records (EMRs) of patients presenting at a U.S. adult endocrinology clinic in 2013. Researchers sought to identify predictors that could contribute to nonattendance or same-day cancellation of scheduled appointments.
Overall, 29,178 patient visits were analyzed; 68% were completed, 20% were canceled 24 hours before the appointment, 7% were canceled less than 24 hours before (same-day cancellation) and 5% were no-shows.
There were 7,043 visits for uncontrolled diabetes, 10,589 visits for controlled diabetes and 11,546 visits for problems other than diabetes. Among appointments for uncontrolled diabetes, 48% of appointments for new patients were no-shows or same-day cancellations compared with 37% for follow-up patients.
A previous history of no-show or cancellation was the most significant predictor for no-show or same-day cancellation (P < .001). Previous discharge from the hospital was the second most significant predictor for no-show or same-day cancellation (P < .001).
Patients with Medicaid Managed Care were more likely to be no-shows or same-day cancelers compared with patients with other insurance types (P < .001). Patients with a longer wait time to their appointment time were more likely to be no-shows or same-day cancelers compared with those with shorter wait times (P = .001). Patients who were scheduled to see a physician were more likely to attend their appointments compared with those scheduled to see an advanced practice registered nurse (P < .001).
Compared with patients with follow-up appointments, new patients were more likely to be no-shows or same-day cancelers (P < .001). Compared with patients with controlled diabetes, patients with uncontrolled diabetes were more likely to miss appointments (P < .001). The appointment was more likely to be attended by patients referred to the practice for nondiabetes-related causes (P = .001).
“Nonattendance occur more commonly in patients with uncontrolled diabetes especially if they are new patients to the endocrine practice,” Eid told Endocrine Today. “Patient engagement — eg, Practice Health Portal, medications prescribed — is associated with better attendance to the clinics. Patients with certain insurance carriers have better attendance to the clinic than others.” – by Amber Cox
Disclosure: The researchers report no relevant financial disclosures.
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