Non‐attendance at out‐patient clinics: a case study

Abstract

Non-attendance at out-patient clinics is a persistent, worldwide problem. In contrast with previous research, a qualitative approach was used in this study to examine reasons for non-attendance at out-patient clinics in one Belfast hospital, by exploring perspectives of general practitioners (GPs), hospital staff and defaulters. Findings revealed conflicts of opinion between GPs and hospital staff on appropriate management of certain medical and postnatal patients. Patients' reasons for defaulting were wide-ranging; however, 32% of those interviewed did not attend, or were recorded as non-attenders, for reasons relating to inefficient hospital administration. It is concluded that the causes of non-attendance were multifactorial, and non-attenders could not be stereotyped as irresponsible. Suggested measures to alleviate the problem include discussion between groups of professionals on responsibility for care of medical and postnatal patients, increased negotiation between patients and physicians in order to develop agreed programmes of care, and, where possible, a shifting of the onus of responsibility for making and cancelling appointments onto patients.

Factors associated with attendance for first appointments at an alcohol clinic and the effects of telephone prompting

“…The most promising indication of patients not replying to the invitation was an association with a longer administrative delay (the delay from the date on the referral letter to an appointment invitation being sent by the clinic). As mentioned before, non-attendance is a combination of administrative as well as patient processes (Mason, 1992), so all efforts to eliminate potential barriers to attendance should be welcomed, for example faxed or e-mailed referrals.…”

“…The reasons for patient non-attendance are varied and contributing factors may include administrative error as well as patient variables (Mason, 1992). For example, a questionnaire study carried out with outpatients who did not attend initial or review appointments revealed that the reasons for non-attendance included forgetting or not receiving the appointment, being too ill to attend, or, conversely, feeling better and no longer in need of the appointment (Pal et al, 1998).…”

Patient Factors Associated with Missed Appointments in Persons with Schizophrenia

“…Rates of missed appointments have been reported to be between 20% and 50% in various mental health settings (1). Previous research on missed appointments in both medical and mental health settings has provided conflicting findings, with some, but not all, researchers finding an association between missed appointments and low socioeconomic status, younger age, low level of education, a history of missed appointments, drug or alcohol abuse, poorer social functioning, having more severe psychiatric problems, and a poor relationship with the physician (2-6).…”

Postoperative follow-up: is a phone call enough?

“…Fewer patients needing clinic appointments means more time is available for new referrals or patients with more complicated diseases [13]. Nonattendance rates at clinic are reduced, which usually occur due to travel difficulties or a perception by patients that no condition warranting medical evaluation exists [14]. In addition, use of medical services and costs are reduced [15].…”