Comprehensive Analysis to Uncover Determinants of Patient Appointment Compliance in Ophthalmology at the Kresge Eye Institute

Abstract

Purpose : Appointment compliance (AC) has a significant impact on physician-patient relationship and overall patient care. However, determinants of AC in Ophthalmology and its subspecialties remains elusive.

Methods : We performed a five-year, January 2014 to December 31, 2018, retrospective analysis across Kresge Eye Institute (KEI) and its affiliated 24 outpatient Michigan locations. A total of 597,364 appointments across >13 subspecialties were included, in which cancellations, testing, pediatric, and spontaneous emergency appointments were excluded. AC was the primary outcome of interest. Compliant (CO) and non-compliant (NC) groups were compared to the following variables: patient characteristics (gender, race, age, insurance), appointment rank (relative to patient history), scheduling location, month, and ophthalmic specialty, in regard to arrival and no-show.

Results : Among all appointments, 59.77% were associated with a female patient and 79.16% of the total number of appointments were compliant. The mean patient age across all appointments was 58.01 years (SD: 20.07 years) with a range of <1 year to 118 years (IQR: 48.09-71.52 years) and depicted a CO of 59.61%. AC differed concerning specialty, with retina representing the highest compliance across all appointments at 23.84%. Among 200+ insurance providers, Medicare was most frequently used and represented the greatest CO at 44.41%. African Americans were the primary ethnicity served by KEI at 61.02% and had the highest number of NC appointments at 73.36%. Appointment month depicted significant compliance in the month of March at 9.02% (p<0.0001). Among appointment locations, KEI General, which had the highest frequency of appointments represented the least compliance with an NC of 36.06%.

Conclusions : Our study demonstrates the impact of patient demographics, appointment characteristics, and ophthalmic subspecialty on AC. A better understanding of these determinants could allow for an increased CO for Ophthalmology practices.

This is a 2021 ARVO Annual Meeting abstract.

 

Figure 1. Procedure for sample selection

 

Table 1. Distribution of Demographic, Administrative, and Appointment Characteristics among compliant and non-compliant appointments at KEI