Characteristics of non-attendance in 1262 children visiting an orthopedic clinic in Israel

Year 2011, Volume: 3 Issue: 3, 2 - 7, 20.07.2011

Arnon Cohen Jacob Dreıher

Abstract

Background and aims: Non-attendance at outpatient clinics is a problem facing every specialty of medicine, and is particularly important in orthopedics ambulatory clinics. We investigated the characteristics of non-attendance in children visiting an orthopedic clinic.
Material and Methods: Non-attendance characteristics were observed for a period of one year in children visiting an ambulatory orthopedic clinic. The parameters extracted were: age, sex, treating orthopedist, waiting time, and timing of the appointment. Chi-square tests were used to analyze statistically significant differences of categorical variables. Logistic regression was used for multivariate analyses.
Results: The study included 1262 first-time visits to the orthopedic clinic. The overall proportion of non-attendance was 27.7%. There was 29.8% non-attendance in females and 26.2% in males (p>0.05). Non-attendance was 27.9% in patients younger than 2 years, 33.8% in patients between 2 and 12 years, and 23.2% in patients above 12 years of age (p=0.001). The proportion of non-attendance was 24.1% when there was a short waiting time for an appointment (7 days or less) and 31.9% when the waiting time was more than 7 days (p=0.002). Non-attendance was 15.9% in rural Jewish, 25.8% in urban Jewish, and 32.6% in Bedouin patients (p=0.002). A multivariate logistic regression model demonstrated that the age of the patient, waiting time for an appointment, and ethnic origin of the patient were significantly associated with non-attendance.
Conclusion: The factors that determine non-attendance in pediatric orthopedic patients are the age of the patient, waiting time for an appointment, and ethnic origin of the patient.

Keywords

Non-Attendance, Orthopedic Clinic, Pediatric, Non-show

References

• Cawley M E, Stevens F M. Non-attendance at outpatient clinics at the Regional Hospital, Galway, Ireland. Soc Sci Med 1987; 25 (11): 1189–96.
• Andrews R, Morgan J D, Addy D P, et al. Understanding paediatric clinics. Arch Dis Child 1990; 65 (2): 192–5. in outpatient
• Kane K. Non-attendance for appointments in an out-patients' x-ray department. Radiogr Today 1991; 57 (653): 15–9.
• Mason C. Non-attendance at outpatient clinics. Nurs Times 1991; 87 (2): 48.
• Potamitis T, Chell P B, Jones H S, et al. Non- attendance at ophthalmology outpatient clinics. J R Soc Med 1994; 87 (10): 591–3.
• Specht E M, Bourguet C C. Predictors of nonattendance at the first newborn health supervision visit. Clin Pediatr (Phila) 1994; 33 (5): 273–9.
• King A, David D, Jones H S, et al. Factors affecting non-attendance in an ophthalmic outpatient department. J R Soc Med 1995; 88 (2): 88–90.
• Bergenmar M, Tornberg S, Brandberg Y. Factors related to non-attendance in a population based melanoma screening program. Psychooncology 1997; 6 (3): 218–26. 9. Wiseman M, McBride M. Increasing the Attendance Rate for First Appointments at Child and Family Psychiatry Clinics: An Opt-in System. Child Psychol Psychiatry Review 1998; 3: 68–71.
• Hardy K J, O'Brien S V, Furlong N J. Information given to patients before appointments and its effect on non-attendance rate. BMJ 2001; 323 (7324): 1298–300.
• Can S, Macfarlane T, O'Brien K D. The use of postal reminders to reduce non-attendance at an orthodontic clinic: a randomised controlled trial. Br Dent J 2003; 195 (4): 199–201.
• George A, Rubin G. Non-attendance in general practice: a systematic review and its implications for access to primary health care. Fam Pract 2003; 20 (2): 178–84.
• Adams L A, Pawlik J, Forbes G M. Nonattendance at outpatient endoscopy. Endoscopy 2004; 36 (5): 402–4.
• Akutsu P D, Tsuru G K, Chu J P. Predictors of nonattendance of intake appointments among five Asian American client groups. J Consult Clin Psychol 2004; 72 (5): 891–6.
• Chung J W Y, Wong T K S, Yeung A C P. Non- attendance at an orthopaedic and trauma specialist outpatient department of a regional hospital. J Nurs Manag 2004; 12 (5): 362–7.
• Bech M. The economics of non-attendance and the expected effect of charging a fine on non- attendees. Health Policy 2005; 74 (2): 181–91.
• Cohen A D, Kaplan D M, Shapiro J, et al. Health Provider Determinants of Nonattendance in Pediatric Otolaryngology Patients. Laryngoscope 2005; 115 (10): 1804–8.
• af Ekenstam J, Hansson L I. Factors influencing outpatient attendance in orthopedic surgery. Lakartidningen 1974; 71 (45): 4491–6 [Swedish].
• Cooper N A, Lynch M A. Lost to follow up: a study of nonattendance at a general paediatric outpatient clinic. Arch Dis Child 1979; 54 (10): 765–9.
• Dyer P H, Lloyd C E, Lancashire R J, et al. Factors associated with clinic non-attendance in adults with type 1 diabetes mellitus. Diabet Med 1998; 15 (4): 339–43.
• Gatrad A R. A completed audit to reduce hospital outpatients non-attendance rates. Arch Dis Child 2000; 82 (1): 59–61.
• Killaspy H, Banerjee S, King M, et al. Prospective controlled study of psychiatric out-patient non- attendance. Characteristics and outcome. Br J Psychiatry 2000; 176: 160–5.
• Lagerlund M, Hedin A, Sparen P, et al. Attitudes, knowledge beliefs, nonattendance in a Swedish population-based mammography screening program. Prev Med 2000; 31 (4): 417–28. as predictors of
• Hull A M, Alexander D A, Morrison F, et al. A waste of time: non-attendance at out-patient clinics in a Scottish NHS Trust. Health Bull (Edinb) 2002; 60 (1): 62–9.
• Spikmans F J M, Brug J, Doven M M B, et al. Why do diabetic patients not attend appointments with their dietitian? J Hum Nutr Diet 2003; 16 (3): 151– 8.
• Dickey W, Morrow J I. Can outpatient non- attendance be predicted from the referral letter? An audit of default at neurology clinics. J R Soc Med 1991; 84 (11): 662–3.
• Kavanagh K T, Smith T R, Golden G S, et al. Multivariate analysis of family risk factors in predicting appointment attendance in a pediatric otology and communication clinic. J Health Soc Policy 1991; 2 (3): 85–102.
• Koch A, Gillis L S. Non-attendance of psychiatric outpatients. S Afr Med J 1991; 80 (6): 289–91.
• Dingle A F, Bingham B, Krishnan R, et al. Pre- admission assessment clinics: an answer to non- attendance for ENT operations. Clin Otolaryngol Allied Sci 1993; 18 (5): 415–8.
• Anderson D N, Aquilina C. Domiciliary clinics I: effects on non-attendance. Int J Geriatr Psychiatry 2002; 17 (10): 941–4.
• Hon K L, Leung T F, Ma K C. Issues regarding nonattendance at a paediatric dermatology centre. Clin Exp Dermatol 2002; 27 (8): 711–3 .
• Hon K L, Leung T F, Wong Y, et al. Reasons for new referral non-attendance at a pediatric dermatology center: a telephone survey. J Dermatolog Treat 2005; 16 (2): 113–6.