Some distinguishing features of patients failing to attend a psychiatric clinic after referral.

Abstract

With outpatient clinics meeting an increasing demand for services from the community, they must use their resources more effectively. Patients who fail to attend after referral represent a failure on the part of the clinic to meet the needs of its community. Identification and understanding of these people's needs might lead to more effective clinic programs.

Customer Approach and Walk-in Clinic Drop-Out Phenomenon

“…Although the appointment is decided in consultation with the patient, many drop out. The percentage of drop-outs described earlier in the literature varies between 26% -64% (4,11,16,17,19).…”

Meaningful linkage practices: Challenges and opportunities

“…Direct contact with outpatient clinicians who will be managing a patient's treatment is rarely made in scheduling appointments. Although reducing the length of time between discharge and the first outpatient appointment has ',een effective in reducing noncompliance with initial visits (Axelrod and Wet-ler, 1989;Raynes and Warren, 1971;Wolkon, Peterson, and Rogawski, 1978), it is unlikely to sustain patients in an ongoing treatment program. Telephone prompting is also of limited value.…”

“…that deemphasized locus of care, assigned inpatient staff to patients (not to the hospital), and focused on integrating various services into patients' care and treatment significantly improved patients' psychosocial functioning and reduced their drug use and antisocial attitudes, but not their symptomatology and psychopathology (Santiago, McCall-Perez, and Bachrach, 1985). The limits of structural proximity alone are illustrated by a study of a hospital-based outpatient program where attendance did not increase when referrals were made from the hospital's own inpatient units (Raynes and Warren, 1971).…”

Dropouts from Treatment

“…Those who failed to attend were much more likely to be of a low socioeconomic status and to have been kept on the waiting list for more than 15 days. Also people who made an appoint ment for themselves were more likely to come than those who were referred by a physician or social agency (8,9),…”