Association between non‐attendance to outpatient clinics and emergency department consultations, hospitalizations and mortality in a Health Maintenance Organization

Diego Hernán Giunta, Marina Alonso Serena, Daniel Luna, Maria Leticia Peroni, Diego Sanchez Thomas, Fernando Binder, Gabriela Alejandra Blugerman, Nora Fuentes, Cristina Maria Elizondo and Fernan Gonzalez Bernaldo de Quirós

International Journal of Health Planning and Management, 2020, vol. 35, issue 5, 1140-1156

Abstract: Background Non‐attendance to scheduled medical appointments in outpatient clinics is a problem that affects patient health and health‐care systems. Objective Evaluate association of non‐attendance to scheduled appointments in outpatient clinics and Emergency Department (ED) visits, hospitalizations and mortality. Methods Retrospective cohort study of outpatients enrolled in 2015 to 2016 in the Hospital Italiano de Buenos Aires HMO with over five scheduled appointments. Individual non‐attendance proportion was obtained by dividing missed over scheduled appointment numbers in the 365 days prior to index date. Outcomes were evaluated with a Cox proportional‐hazards or Fine and Gray model for competing risks. We adjusted by several variables. Results Sixty‐five thousand two hundred sixty‐five adults were included. Mean age was 63.6 years (SD 18.16), 29.9% male. Outpatients had average 10.18 (SD 5.59) appointments. Non‐attendance the year before the index appointment had a median of 20%. A 10% increase in non‐attendance was significantly associated with ED visits (asHR 1.19; 95%CI 1.08‐1.32, P

Date: 2020
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