Background Failure to keep medical appointments results in inefficiencies and, potentially, in poor outcomes for patients. The aim of this study is to describe non-attendance rate and to investigate predictors of non-attendance among patients receiving hospital outpatient treatment for chronic diseases. Methods We conducted a historic, register-based cohort study using data from a regional hospital and included patients aged 18 years or over who were registered in ongoing outpatient treatment courses for seven selected chronic diseases on July 1, 2013. A total of 5895 patients were included and information about their appointments was extracted from the period between July 1, 2013 and June 30, 2015. The outcome measure was occurrence of non-attendance. The associations between non-attendance and covariates (age, gender, marital status, education level, occupational status, specific chronic disease and number of outpatient treatment courses) were investigated using multivariate logistic regression models, including mixed effect. Results During the two-year period, 35% of all patients (2057 of 5895 patients) had one or more occurrences of non-attendance and 5% of all appointments (4393 of 82,989 appointments) resulted in non-attendance. Significant predictors for non-attendance were younger age (OR 4.17 for 18 ≤ 29 years as opposed to 80+ years), male gender (OR 1.35), unmarried status (OR 1.39), low educational level (OR 1.18) and receipt of long-term welfare payments (OR 1.48). Neither specific diseases nor number of treatment courses were associated with a higher non-attendance rate. Conclusions Patients undergoing hospital outpatient treatments for chronic diseases had a non-attendance rate of 5%. We found several predictors for non-attendance but undergoing treatment for several chronic diseases simultaneously was not a predictor. To reduce non-attendance, initiatives could target the groups at risk. Trial registration This study was approved by the Danish Data Protection Agency (Project ID 18/35695 ). Electronic supplementary material The online version of this article (10.1186/s12913-019-4208-9) contains supplementary material, which is available to authorized users.
Background: Most people would prefer to die at home. Engaging citizens in end-of-life care may contribute to making home death possible for more people. Aims: To test the feasibility and acceptability of Last Aid Courses in different countries and to explore the views and experiences of participants with the course. Methods: International multi-centre study with a questionnaire based mixed methods design. 408 Last Aid Courses were held in three different countries. Of 6014 course participants, 5469 participated in the study accounting for a response rate of 91%. Results: The median age of participants was 56 years. 88% were female. 76% of participants rated the course "very good". 99% would recommend it to others.. Findings from the qualitative data revealed that participants found the atmosphere comfortable; instructors competent; appreciated the course format, duration, topics and discussions about life and death. Conclusions: Last Aid Courses are both feasible and accepted by citizens from different countries. They have a huge potential to inform citizens and to encourage them to engage in care at home. Future research should investigate the long-term effects of the course on the ability and willingness of participants to provide end-of-life care and the impact on the number of home-deaths.
Background:The increasing prevalence of patients with multimorbidity in the general population affects the health-care system. There is a lack of knowledge of the proportion of patients attending multiple hospital outpatient specialty clinics simultaneously.Objective:This study describes the development in the proportion of patients managed simultaneously in multiple hospital outpatient specialty clinics.Design:We obtained three cross-sectional samples from all of the hospitals in Denmark. The data set consists of adults (age 18+) in long-term outpatient care on January 1 in 2004, 2009, and 2014 with one or more of 50 consensus-selected chronic diseases. Descriptive statistics were used to examine and compare the proportion of patients treated simultaneously in multiple outpatient specialty clinics. We also investigated the most common combinations of outpatient specialty clinics.Results:In 2004, 176,786 patients with chronic diseases were registered as receiving outpatient care in Denmark. This figure increased to 246,542 patients in 2009 and 341,015 in 2014. The proportion of patients managed simultaneously in multiple outpatient specialty clinics was 4.0% in 2004, 5.5% in 2009, and 7.7% in 2014. The most common specialty clinic combination was endocrinology and cardiology, accounting for 12.1% in 2004, 11.5% in 2009, and 9.6% in 2014.Conclusions:The proportion of patients in multiple clinics nearly doubled over a 10-year period. While there were some common specialty clinic combinations in which patients were treated most often, there was also considerable variation. Further studies are needed to identify generic and disease-specific initiatives.
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