Patient Factors Associated with Missed Otolaryngology Appointments at an Urban Safety‐Net Hospital

Author:

Wilson Carolyn A.1ORCID,Jamil Taylor L.123,Velu Preetha S.1ORCID,Levi Jessica R.14ORCID

Affiliation:

1. Boston University Chobanian & Avedisian School of Medicine Boston Massachusetts U.S.A.

2. Boston University School of Public Health Boston Massachusetts U.S.A.

3. Department of Otolaryngology‐Head and Neck Surgery University of Colorado Aurora Colorado U.S.A.

4. Department of Otolaryngology–Head and Neck Surgery Boston Medical Center Boston Massachusetts U.S.A.

Abstract

ObjectiveTo determine if patient factors related to ethnicity, socioeconomic status (SES), medical comorbidities, or appointment characteristics increase the risk of missing an initial adult otolaryngology appointment.MethodsThis study is a retrospective case control study at Boston Medical Center (BMC) in Boston, Massachusetts, that took place in 2019. Patient demographic and medical comorbidity data as well as appointment characteristic data were collected and compared between those that attended their initial otolaryngology appointment versus those who missed their initial appointment. Chi‐square and ANOVA tests were used to calculate differences between attendance outcomes. Multivariate analysis was used to compare the odds of missing an appointment based on various patient‐ and appointment‐related factors.ResultsPatients who were more likely to miss their appointments were more often female, of lower education, disabled, not employed, Black or Hispanic, and Spanish‐speaking. Spring and Fall appointments were more likely to be missed. When a multivariate regression was conducted to control for social determinants of health (SDOH) such as race, insurance status, employment, and education status, the odds of females, Spanish‐speaking, students, and disabled patients missing their appointment were no longer statistically significant.ConclusionA majority of patients at BMC come from lower SES backgrounds and have multiple medical comorbidities. Those who reside closer to BMC, often areas of lower average income, had higher rates of missed appointments. Interventions such as decreasing lag time, providing handicap‐accessible free transportation, and increasing accessibility of telemedicine for patients could help improve attendance rates at BMC.Level of EvidenceIV Laryngoscope, 134:4003–4010, 2024

Publisher

Wiley

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