Evaluation of high blood pressure control programs using provider surveys as instruments for process measurement: Anthony V. Sardinas, Connecticut State Department of Health, 79 Elm Street, Hartford, Connecticut, 06115; Maria A. Buatti

Abstract

Objective. The purposes of this study were to compare the sociodemographic and health-related characteristics of orofacial injury patients who miss appointments with those of patients who do not and to determine which patient characteristics best predict missed-appointment behaviors (eg, the number of missed clinic visits). Study design. A total of 190 patients (134 African American and 56 Hispanic) treated for mandible fractures at the King/Drew Medical Center, Los Angeles, participated in a prospective study involving structured interviews at 4 points (denoted recalls 1-4 ) over a 6-month period. To be included in the study, patients were required to have attended recall 1. Most patients in the study sample were male, more than 32 years of age, unmarried, and unemployed; most had completed high school; and most had sustained their injuries as a result of assault. Results. Only 22% of the patients attended all 4 recall clinic appointments. However, 42% completed 3 recall visits, and 69% completed 2 recall visits. Patients who missed appointments were more likely to be African American than Hispanic and more likely to be unemployed than employed. There was a significant negative association between perceived social support and missed appointments (r = –0.18, P = .01). Patients who missed more appointments perceived themselves to have less social support than those who missed fewer or no appointments. The data revealed no associations between missed appointment behavior and age, gender, marital status, or education. None of the health-related variables investigated were associated with missed appointments. Multiple regression analysis confirmed that race, unemployment, and perceived social support were the best predictors of missed appointments. Conclusions. Social variables have a greater impact than health variables in predicting missed-appointment behavior. Unemployed African American patients are at the greatest risk for missing recall clinic appointments; however, this finding is independent of health insurance. Accessing and enlisting patients’ social networks to support follow-up medical care has potential for improving appointment-keeping behavior and should be further examined. (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1999;87:405-10)