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Israel Ojalvo, Nikki Angela Mehran, Qiang Zhang, Jonathan S Myers, Reza Razeghinejad, Daniel Lee, Natasha Kolomeyer; Factors Associated with Cancellations and ‘No-Shows’ in Glaucoma Patients. Invest. Ophthalmol. Vis. Sci. 2020;61(7):4262.
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Glaucoma is often an insidious disease, prone to decreased patient adherence to appointments as well as treatments. Nonadherence to appointments has been associated with severe glaucomatous defects. This retrospective study aims to identify factors associated with appointment cancellations and ‘no shows’ in a glaucoma clinic.
A retrospective review of appointment records from a glaucoma clinic in an urban tertiary eye care hospital from June 1, 2017 – May 31, 2019 was performed, resulting in 36,810 visits from 7383 individual patients. The visits were divided into three groups based on appointment status: kept (64.6%), cancelled (23.5%), and no-show (11.8%). Data collection included clinic type (resident vs. private), patient age, gender, insurance, and appointment type. Patient distance from the clinic was calculated as miles from patient’s zip code to the clinic using a Bing Maps Application Programming Interface which utilized the fastest route.
Univariate analysis found a statistically significant difference in various factors including age, gender, and travel distance amongst patients based on appointment status (kept, cancelled or no-show; Kruskall-Wallis, Fishers exact test, Wilcoxon rank sum). Patients closer to the clinic (< 15 miles) had a higher rate of ‘no show’ but a lower rate of cancellations compared to those who travelled farther (p< 0.0001, logistic regression). Using multivariable logistic regression the following factors were (positively or negatively) associated with patient ‘no-show’: resident clinic [OR 1.79 (95% CI: 1.67, 1.98)], appointment type [OR 0.79 (95% CI: 0.67, 0.91)], male gender [OR 1.12 (95% CI: 1.05,1.19)], and age [OR 0.99 (95% CI: 0.98, 0.99)]. A multivariable logistic regression was also used to calculate factors associated (positively or negatively) with patient cancellations: female gender [OR 1.16 (95% CI: 1.10, 1.23)]; appointment type [OR 0.62 (95% CI: 0.41, 0.94)]; and travel distance [OR 0.89 (95% CI: 0.84, 0.94)].
Travel distance, gender, age, appointment type, and clinic type (resident vs. private) were found to be significant factors influencing rates of patient cancellations and/or no-shows in glaucoma clinic. It is important to understand these risk factors to be able to anticipate and design interventions to improve appointment adherence.
This is a 2020 ARVO Annual Meeting abstract.
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