Background The Bluegrass Care Clinic (BCC), a university based HIV/AIDS clinic, has an annual average patient no show rate of 13.6% to medical appointments. Treatment adherence greater than 95% is needed to obtain maximum benefits of therapy and minimal disease progression requiring attendance to regularly scheduled medical appointments throughout the patient's lifespan. Missed appointments are not only known to interfere with appropriate care but to misspend medical and administrative resources. The BCC sought to identify demographic trends, interpret perception and identify barriers unique to those individuals who frequently do not attend appointments.
Methods Quantitative and qualitative data were collected through focus groups, phone surveys and data from Resource Scheduling Software. Descriptive statistics (frequencies and means) were derived.
Results During a 29 month period the BCC expended roughly $3864 per month due to patients who did not show for appointments. 68 individual patients did not show for more than eight appointments. These 68 patients accounted for 21% of missed appointments, while 1053 patients accounted for the other 79% of missed appointments see Abstract P3-S3.07 figure 1. 13 patient focus groups were held where members cited transportation/coping/stress as potential barriers to attendance. During a phone survey of the 68 individuals only one individual correctly estimated the average number of appointments they missed per year. Female clients seem to disproportionately become frequent non-attenders as compared to their male counterparts. Female clients make up only 20% of the general BCC population, while they make up 34% of the clients who frequently miss appointments. There is a disproportionate effect in black clients. These individuals make up 21% of the BCC's total client population, while they make up 29% of the clients that frequently do not attend appointments.
Conclusions Surprisingly, a disproportionate percentage of individuals account for 1/5 of patients who do not attend or cancel appointments. Individuals surveyed by phone the majority had no actual perception of the average number of appointments they miss without cancelling. Interestingly, although the BCC serves 63 counties, 78% of those who frequently miss appointments live in the immediate area (within 30 miles of the BCC)- so transportation barriers that were identified during focus group sessions may not have a significant impact on those who frequently miss appointments.
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