Ethnicity, Marital Status, Primary Care Provider Status and Appointment Wait Time Predict Attendance at Outpatient Gastroenterology Clinic

Abstract

Introduction: Missed clinic appointments reduce clinic efficiency, waste resources and increase costs. Limited data exists on subspecialty clinic attendance. The only US study to examine the factors associated with missed gastroenterology clinic attendance was performed in an urban safety net healthcare population. The goal of this study was to identify the factors associated with missed appointments at a gastroenterology (GI) clinic in an academic setting. Methods: We performed a case-control study using data from the electronic health record (EHR) of patients scheduled for an appointment at one of the adult GI clinics at the University of Arizona Medical Center between 03/03/2014 and 10/31/2014. Patients who missed their clinic appointment during the study period served as cases. Controls were randomly selected from patients who completed their appointment during the study period. Univariate and Multivariate logistic regression analysis were utilized for the data analysis.Table 1: Logistic regression analysis of factors associated with missed clinic appointments.Results: Of 2,331 patients scheduled for appointment, 195 (8.4%) missed their appointment. A random sample of 390 controls was selected from patients who completed their clinic appointment. In the final analysis, there were 192 cases (33.6%) and 379 controls (66.4%). Age, ethnicity, marital status, employment status, primary care status and time from referral to appointment were associated with missed appointment in Univariate analysis. In Multivariate analysis, time from referral to appointment was strongly associated with missed clinic appointment; patients with appointment >28 days from referral were more likely to miss their appointment than patients with appointment in ≤28 days (adjusted odds ratio [AOR] 2.6[1.7,4.0]). Patients with primary care provider were less likely to miss their clinic appointment than those without primary care provider (AOR 0.36[0.2,0.6]). Hispanic (AOR 1.9[1.2,3.2]) and Native American (AOR 6.8[1.9,23.5]) patients were more likely than Caucasian patients to miss their clinic appointment. Single patients were more likely than married patients to miss their appointment (AOR 1.9[1.2,3.0]). Conclusion: Longer time from referral to appointment, ethnicity and marital status were strongly associated with missed clinic appointment. Patients with primary care provider were less likely to miss their clinic appointment than patients without primary care provider. Development of directed strategies that account for these factors involved in GI clinic attendance can enhance patient care and reduce costs.