Characteristics of non-attendances at Hospital Authority Staff Clinic of a regional hospital, a case control study.

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Abstract Summary
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Authors (including presenting author) :
LM Yau, TK Wong, YC Lau, DVK Chao
Affiliation :
Department of Family Medicine and Primary Health Care, United Christian Hospital, Kowloon East Cluster, Hospital Authority, Hong Kong
Introduction :
Hospital Authority Staff Clinics (HASC) provides primary care services to all eligible HA employees and their dependents. Patients can book their appointment through telephone booking system (IVAS) or smartphone app (App) within 3 working days from the appointment. Doctors can also arrange follow-up for patients through registration counter according to clinical indication. With increasing number of HA staff, the demand for HASC consultation is ever increasing. Non-attendance to HASC represents a significant cost in terms of time and resources lost. Reducing non-attendance rate can be one of the important steps to improve HASC utilization and save cost, in addition to other measures to cope with the demand.
Objectives :
To analyze the characteristic of non-attendance in HASC of United Christian Hospital (UCH).
Methodology :
This is a retrospective review of the booking characteristics of defaulters and attendees who successfully booked an appointment at HASC of UCH from 1/11/2017 to 31/10/2018. Odds ratio was used for comparison.
Result & Outcome :
A total of 18,389 appointments were booked in the study period and 1,831 episodes of non-attendance were identified. Among different booking methods, those episodes booked through IVAS were more likely to default the appointment relative to those booked through registration counter (OR 1.51, C.I. 1.33-1.71). The odds ratio of those booked through App was 1.37 (C.I. 1.19-1.58). Compared to those with long booking interval (more than 2 weeks), those episodes booked at 2 days before the appointment carried the highest likelihood of non-attendance (OR 1.53, C.I. 1.32-1.78), followed by those booked between 6 days to 2 weeks (OR 1.43, C.I. 1.06-1.94) and those booked 1 day before (OR 1.37, C.I. 1.15-1.62). Those episodes booked within the same day of the appointment were least likely to default (OR 0.51, C.I. 0.42-0.62). In addition, female and patients with younger age were also associated with higher default rate. Specific measures can be formulated to target patients booked within 1-2 days before the appointment, for example, a reminder system for those patients and more easy ways to cancel their appointment if no longer necessary in particular for those using IVAS. On the other hand, some quota reservation may be considered for same day booking to provide timely care for staff with acute medical problems.

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