Non-attendance behavior at a general ophthalmic outpatient clinic in Hong Kong - the patient's perspective

Abstract

Aim: Non-attendance at outpatient clinics is a universal phenomenon and an important obstacle to providing effective and efficient health care. The aim of the present study was to evaluate the reasons given by patients for failing to attend a scheduled appointment at a general ophthalmic outpatient clinic. 

Patients and methods:  All patients who failed to attend follow-up appointments in the general ophthalmic outpatient clinic at the Hong Kong Eye Hospital during 1 week were prospectively recruited for a standardized telephone interview. Logistic regression analyses were performed to identify factors associated with the most common reason for non-attendance. 

Results: Of the 3265 patients scheduled to attend the out­ patient clinic, 448 (15.2%) defaulted. The most common reasons for non-attendance were forgetfulness (49.3%), being busy (10.4%), or being unwell on the appointed day (9.4%). Logistic regression analysis showed that pa­ tients with a longer elapsed ti me since the last follow-up were more likely to forget the appointment (adjusted odds ratio, I .11 per month; 95% confidence interval, 1.04-1.19), while patient s who were aware of impairment in independent activities of daily Jiving were less likely to for­ get (adjusted odds ratio, 0.53; 95% confidence interval, 0.29-0.95). Most respondent s felt that a follow-up re­ minder would have been useful, with more patients preferring telephone reminders to mail reminders.

Conclusion: Outpatient non-attendance is a common phenomenon in this tertiary-level eye center. Targeted strategies such as a telephone reminder system, health education, and clinic orientation videos may reduce patient default, especially for individuals with a long in­ terval between follow-up appointments.