Socioeconomic factors that impact patient no-shows in the ambulatory urology clinic
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ORIGINAL ARTICLE
Socioeconomic factors that impact patient no-shows in the ambulatory urology clinic Sabine Nguyen 1 & Angela M. Massey 1 & Daniel Norez 1 & Shiva Gautam 1 & Karthik Tanneru 1 & Jatinder Kumar 1 & Muhammed Alam 1 & Soroush Bazargani 1 & Seyedbehzad Jazayeri 1 & Mark Bandyk 1 & Hariharan Ganapathi 1 & Robert Marino 1 & Shahriar Koochekpour 1 & Joseph Costa 1 & K. C. Balaji 1 Received: 28 February 2020 / Accepted: 29 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Aim This study seeks to identify patient socioeconomic factors that may be associated with no-shows to our academic urology clinics. Subject and methods This was a retrospective analysis of patient attendance to appointments scheduled at the main urology clinics of our academic center between April 2018 and April 2019. Attendance to scheduled appointments was computed and analyzed with respect to patients’ demographics and socioeconomic status, along with clinic site, type of provider scheduled with, and reason for visit. Chi-square test and simple and multiple logistic regression were performed in order to determine the relationship between patient no-show rates and the variables for appointment characteristics. Results The cohort of patients at highest risk for no-show was associated with those who were uninsured (OR = 30.00, 95% CI: 23.73-–7.92; p < 0.0001) and from our county’s urban sector (OR = 1.96, 95% CI:1.63–2.37; p < 0.0001), in which the population reported a household income of 30% below poverty level and was only one-third high-school educated. Conclusion Further studies of this at-risk population who are likeliest to miss their urology clinic appointment may appropriately address these patients’ needs and thus curtail the number of no-shows to future outpatient appointments. Keywords No-show . Clinic attendance . Socioeconomic and health disparity
Introduction Patient no-show, or non-attendance, to outpatient appointments is costly on many fronts. According to a 2017 report, patient no-shows cost the US healthcare system up to $150 billion annually (Gier 2017). Aside from the financial fallout, however, the consequences of missed outpatient appointments can lead to increased patient morbidity and mortality due to the delay in diagnoses and treatment (Kheirkhah et al. 2016; McQueenie et al. 2019). In surgical subspecialty clinics such as in urology, missed visits can be doubly costly for patients, as opportunity for in-office procedures or potential surgical planning may be lost as well. While factors affecting outpatient ambulatory visit no-shows can be wide ranging across
* K. C. Balaji [email protected] 1
Department of Urology, University of Florida, Jacksonville, 653 West 8th Street, Jacksonville, FL 32209, USA
specialties, identifying the most impactful causes for patient no-shows unique to each clinical context is imperative in order to reduce healthcare costs and improve the quality in delivery of care (Briatore et al. 2019; Cohen-Yatziv et al. 2019; Kheirkhah et al
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