Abstract
Purpose :
The purpose of our study is to examine factors that influence no-show rates in a resident intravitreal injection clinic. Specifically focusing on community income level of the patient and weather to help determine barriers to care in an urban population at a tertiary care center.
Methods :
Retrospective analysis was conducted of all charts from a resident run intravitreal injection clinic in Detroit, Michigan from January to November 2018. Charts were classified as a no-show or a show for an appointment and demographic information including patients’ age, race, sex, diagnosis, visual acuity, and zip code were recorded. Community income level was derived using patients self reported zip code and the US Census Bureau American Community Survey 2016.
Resident intravitreal injection clinic was held on Monday mornings. No show rates per injection clinic were recorded from December 4th, 2017 through November 26th, 2018. Weather data at noon was date matched from the United States National Weather Service for Detroit, Michigan.
Results :
110 patient appointments were identified. 24 charts were identified where a patient was a no-show for their appointment and 86 charts were identified where a patient showed for their scheduled appointment. The average community income for no-show patients was $26,170 and $31,926 for patients who attended their appointment (p=0.01). There was a 22% difference in relation to community income level between the two groups. 35 weeks of weather data was recorded for Monday mornings where a resident held an injection clinic (clinics were cancelled during resident vacation and holidays). The no-show rate when the temperature was greater than 70 degrees Fahrenheit (15 out of 35 weeks) was 14.5% while the no-show rate when the temperature was below 70 degrees Fahrenheit (20 out of 35 weeks) was 25.6% (p=0.02). The number of injection clinics with a 100% show rate was 6 and 1 respectively.
Conclusions :
In conclusion, colder temperatures and community income level both act as barriers to care in an urban resident intravitreal injection clinic. By studying factors that increase our patients' no show rate we can begin to identify patients who are at high risk of increased visual morbidity from missed intravitreal injection appointments.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.