Does pain take holidays? Non-attendance rates at a hospital-based pain clinic are elevated during the Jewish high-holidays

Abstract

BackgroundPatient non-attendance is an expensive and persistent problem worldwide with rates between 5–39% reported in the literature. The objective of the study was to assess whether there is a higher incidence of non-attendance in a hospital-based pain clinic during the period of the Jewish High Holidays (Rosh-Hashanah to Sukkot) and whether this is further compounded by other factors, such as demographic characteristics and previous visits to the clinic.MethodsRecords were taken from the Lowenstein Rehabilitation Hospital appointment scheduling system. Data was gathered from two time-periods: High-Holidays and Control for each year, over a total of 6 years 2008–2013. Non-attendance was analyzed by period, by age, by gender and by previous visits to the clinic.ResultsIn the entire population studied (666 distinct records), the non-attendance rate was higher during the High-Holidays as compared to the Control period (32 vs. 24.1%; p = 0.030). Non-attendance rates were significantly higher during the Holidays among repeating patients (28.6 vs. 14.8%; p = 0.002) and among women (34.6 vs. 20.7%; p = 0.004).DiscussionOur data suggest that non-attendance is elevated during the High-Holidays in specific groups of patients, namely, repeating patients and women. Despite no direct inquiry into the reasons for non-attendance, we speculate that the elevated well-being and familial support during the holidays contribute to the patients’ ability to cope with persistent pain and possibly directly reduce the amount of pain, leading to patients missing their pain clinic appointments.ConclusionOur results, provided they can be corroborated by larger-scale studies, can assist in scheduling policy adjustments such as avoidance of appointments during the High-holidays for specific patient populations and more rigorous reminder efforts during these times of the year that may lead to reduction in overall non-attendance rates in the pain clinic. Further, our data provide an impetus for further studies of non-attendance patterns among pain clinic patients, in order to acquire a better understanding of the reasons for non-attendance and develop strategies to reduce it and thus contribute to the continuous improvement of the Israeli health systems as well as others worldwide.Electronic supplementary materialThe online version of this article (doi:10.1186/s13584-017-0132-9) contains supplementary material, which is available to authorized users.

Factors Associated with Nonattendance to a Geriatric Clinic among Mexican Older Adults

“…In a hospital-based pain clinic during the Jewish High Holidays, there was a higher rate of NA. The authors of this study speculate that since holidays provide a variety of opportunities for receiving social and instrumental support, distraction from the pain, and reduced focus on the body, they may also serve to distance the patient from everyday stressors and assist in better handling chronic pain or in alleviating it [32]. Nevertheless, this is still to be proven and the role of pain and OA to be further investigated in the context of NA.…”

What do we know about no‐show behavior? A systematic, interdisciplinary literature review

“…Here, we observe some evidence for a relationship in the form of an inverted u‐shape, indicating that the probability of NSB is, in fact, likely to increase as the patient ages, but only to a certain point after which the effect reverses (e.g., Bellucci et al., 2017). Somewhat more precisely, previous studies have located this turning point somewhere between 20 (Harvey et al., 2017) and 64 years (Ratmansky et al., 2017), once more leaving room for more nuanced research in the future; that is, research that refrains from exploring age by adding age clusters rather than metric information (e.g., Chua & Chow, 2019), comparing mere medians (e.g., Briatore et al., 2020), or even excluding certain age groups (e.g., Bell et al., 2020).…”

“…1212Interestingly, these 34 contributions to the literature were generated across various markets, i.e., Argentina (1 contribution; Briatore et al., 2020), Australia (2; e.g., Bellucci et al., 2017), Belgium (1; Goossens et al., 2021), China (1; Hu et al., 2020), Denmark (2; e.g., Wolff et al., 2019), Ireland (1; Hannan et al., 2021), Israel (1; Ratmansky et al., 2017), Mexico (1; Negrete‐Najar et al., 2021), New Zealand (1; Lamba et al., 2019), Singapore (2; e.g., Chua & Chow, 2019), South Korea (2; e.g., Suk et al., 2021), Taiwan (1; Tsai et al., 2019), and the United States (18; e.g., Rosenbaum et al., 2018) and should, therefore, add to our understanding of the robustness of the observed effects. Here, perhaps a bit surprising, we neither observe continent nor country‐specific differences in the reported NSRs.…”

Evaluation of the Use of Telehealth Video Visits for Veterans With Chronic Pain

“…Multiple factors are associated with missed appointments including accessibility of specialized services and inability to travel due to impaired mobility, transportation issues, or financial hardship ( Hwang et al., 2011 ; Odonkor et al., 2017 ; Ratmansky et al., 2017 ; Shaparin et al., 2014 ). Telehealth video visits enable patients to receive health care services without needing to travel to the nearest medical facility ( Eaton et al., 2014 ; Finkelstein et al., 2020 ; Jacobs et al., 2019 ; Viers et al., 2015 ).…”

“…Approximately 20% of the U.S. population are affected with chronic pain, and approximately 50% of U.S. military veterans regularly experience some type of chronic, persistent pain ( Adams et al., 2021 ; Dahlhamer et al., 2018 ). When chronic pain is untreated or undertreated, deleterious effects, such as functional limitation, physical disability, and psychologic distress, can occur ( Fine, 2011 ; Ratmansky et al., 2017 ). In many instances, patients experience negative emotions, such as anxiety and stress, which often trigger or worsen symptoms of pain ( Lovo et al., 2019 ).…”