Fri0610 patient non-attendance characteristics at rheumatology outpatient clinics within a large multi-ethnic region
Authors: A. Takyi, K. Sunmboye
Journal: Annals of the Rheumatic Diseases (2018)

<h3>Background:</h3> Patient non-attendance for outpatient appointments is increasingly becoming more important in an era where resources have to be used in the most cost effective way. The Leicestershire region of the United Kingdom has a very diverse multi-ethnic population of just over 1 million people. Across 3 large hospital sites the University Hospitals of Leicester, United Kingdom caters for the rheumatology needs of this diverse population. <h3>Objectives:</h3> The aim of our observational study was to identify the patient characteristics of the non-attenders and investigate if ethnicity and socioeconomic class contribute to the non-attendance rate. <h3>Methods:</h3> The study was based on patient appointments scheduled at a busy rheumatology outpatient clinic across three large hospital sites from January 2017 to June 2017. Extensive data on various outcomes such as cancellation on the part of the patients and non-attendance from the patients without giving formal notice were collected from the main electronic administrative systems of three hospitals in the region. The data for the appointment characteristics were also collected. Logistic regression was used for statistical analysis. <h3>Results</h3> Of the 22,011 appointments scheduled over the study period. The non-attendance rate of 3.5% was recorded for this study period without the patients giving notice. The age range of the study population was 16 to 95 years. The median age was 50 years. Majority (24%) of non-attenders were in the 45–54 year age bracket. The 85–95 year age group had the lowest non-attendance rate at 2%. When the data was analysed for ethnicity, the percentage of patients who did not attend in the black Asian and minority ethnic group (BAME) was 44%. Only 33% of the study population were recorded on the hospital database as employed. The reminder included retirees (29%), students (4%) whilst the remaining 34% were either unemployed or we had no formal recording of their employment status. <h3>Conclusions:</h3> The cost implications of missed appointments is so significant that even small percentage reductions in non-attendance rates could lead to significant savings. Various studies have identified many contributory factors such as age and ease of access to hospital facilities. Few studies have looked at the role of ethnicity and socioeconomic class. From our data there was a significant (P value &lt;0.05) difference between the employed and unemployed group. The working class group also had a significant non-attendance rate which suggests that more can be done at looking at the appointment scheduling by the health service provider. Patient factors are likely to play a role in the BAME group not attending hospital appointments. The existing letter and text reminder service might need to explore several language options as this may play a contributory role in non-attendance rates. Addressing these issues may go a long way in ensuring that existing resources are not wasted due to non-attendance. <h3>References</h3> 1. Ellis AD, et al. Demographic and practice factors predicting repeated non-attendance in primary care: a national retrospective cohort analysis. Lancet Public health2017Dec;2(12):e551–e559. 2. Blæhr EE, et al. Observational study identifies non-attendance characteristics in two hospital out-patient. Clinics Dan Med J2016October;63/10. <h3>Acknowledgements:</h3> Dr Kehinde Sunmboye <h3>Disclosure of Interest:</h3> None declared