Sociodemographic and Clinical Factors Associated with Nonattendance at the Hepatology Clinic

• Published in: Digestive diseases and sciences 2023-06, Vol.68 (6), p.2398-2405
• Main Authors: Rustam, Louma Basma, Vander Weg, Mark, Chrischilles, Elizabeth, Tanaka, Tomohiro
• Format: Article
• Language: English
• Subjects: Absenteeism; Ambulatory Care Facilities; Appointments and Schedules; Biochemistry; Case-Control Studies; Development and progression; Gastroenterology; Hepatitis; Hepatitis C; Hepatitis C - diagnosis; Hepatitis C - epidemiology; Hepatology; Humans; Liver; Liver diseases; Medicaid; Medical colleges; Medical records; Medical research; Medicine; Medicine & Public Health; Medicine, Experimental; Oncology; Original Article; Outpatient Clinics, Hospital; Regression analysis; Sociodemographics; Transplant Surgery; Worker absenteeism
• ISSN: 0163-2116; 1573-2568
• DOI: 10.1007/s10620-023-07951-z

Background Absenteeism from clinic appointments reduces efficiency, wastes resources, and contributes to longer wait times. There are limited data regarding factors associated with nonattendance in hepatology clinics. Identifying factors related to appointment nonattendance may help in the design of interventions for reducing absenteeism. Methods We aim to identify sociodemographic, clinical, and appointment-related factors associated with absenteeism following referral to a liver clinic in a tertiary academic center located in the US Midwest. We designed a case–control study using data from electronic medical records of patients scheduled for appointments between January 2016 and December 2021. Cases were defined as patients who canceled appointments on the same day or resulting in no-shows, and controls were those who completed the referral visit. Information about patients’ sociodemographic characteristics, appointment details, and etiology of liver disease were recorded. Hierarchical logistic regression was used to analyze factors related to nonattendance. Results Of 3404 scheduled appointments, 460 (13.5%) missed visits were recorded. In the multivariable logistic regression models, hepatitis C and alcohol-associated liver disease were associated with greater odds of nonattendance [odds ratio (OR) 4.0 (95% CI 3.2–4.9), OR 2.7 (1.7–4.2), respectively] compared to those with other liver disease. Sociodemographic characteristics associated with risk of nonattendance included being Black [OR 2.6, (1.8–3.7)], Medicaid insurance or no insurance [OR 2.3 (1.7–2.9), OR 2.5 (1.6–3.7), respectively], non-English speaking [OR 1.8 (1.1–3.1)], being unmarried [OR 1.8 (1.4–2.2)], and longer wait time (> 30 days) until appointments [OR 1.8 (1.5–2.2)]. Conclusion Several sociodemographic and administrative characteristics, as well as hepatitis C and alcohol-associated liver disease were associated with appointment nonattendance. Targeted future interventions may help to decrease nonattendance.