Understanding repeated non-attendance in health services: a pilot analysis of administrative data and full study protocol for a national retrospective cohort

Williamson, A., Ellis, D. A., Wilson, P., McQueenie, R. and McConnachie, A. (2017) Understanding repeated non-attendance in health services: a pilot analysis of administrative data and full study protocol for a national retrospective cohort. BMJ Open, 7(2), e014120. (doi:10.1136/bmjopen-2016-014120) (PMID:28196951) (PMCID:PMC5319001)

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Abstract

Introduction: Understanding the causes of low engagement in healthcare is a pre-requisite for improving health services’ contribution to tackling health inequalities. Low engagement includes missing healthcare appointments. Serially (having a pattern of) missing general practice (GP) appointments may provide a risk marker for vulnerability and poorer health outcomes. Methods and analysis: A proof of concept pilot using GP appointment data and a focus group with GPs informed the development of missed appointment categories: patients can be classified based on the number of appointments missed each year. The full study, using a retrospective cohort design, will link routine health service and education data to determine the relationship between GP appointment attendance, health outcomes, healthcare usage, preventive health activity and social circumstances taking a life course approach and using data from the whole journey in the National Health Service (NHS) healthcare. 172 practices will be recruited (∼900 000 patients) across Scotland. The statistical analysis will focus on 2 key areas: factors that predict patients who serially miss appointments, and serial missed appointments as a predictor of future patient outcomes. Regression models will help understand how missed appointment patterns are associated with patient and practice characteristics. We shall identify key factors associated with serial missed appointments and potential interactions that might predict them. Ethics and dissemination: The results of the project will inform debates concerning how best to reduce non-attendance and increase patient engagement within healthcare systems. Significant non-academic beneficiaries include governments, policymakers and medical practitioners. Results will be disseminated via a combination of academic outputs (papers, conferences), social media and through collaborative public health/policy fora.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:McConnachie, Dr Alex and Wilson, Dr Philip and Williamson, Dr Andrea and McQueenie, Dr Ross
Authors: Williamson, A., Ellis, D. A., Wilson, P., McQueenie, R., and McConnachie, A.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Social Scientists working in Health and Wellbeing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:BMJ Open
Publisher:BMJ Publishing Group
ISSN:2044-6055
ISSN (Online):2044-6055
Published Online:14 February 2017
Copyright Holders:Copyright © 2017 The Authors
First Published:First published in BMJ Open 7(2):e014120
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
678281Investigating the importance of serial missed appointments in the NHS: a linkage pathfinder project of general practice, health, social care and education data.Andrea WilliamsonScottish Executive Health Department (SEHHD-CSO)CZH/4/1118MVLS MED - UNDERGRADUATE SCHOOL