Educational associations with missed GP appointments for patients under 35 years old: administrative data linkage study

McQueenie, R., Ellis, D. A., Fleming, M. , Wilson, P. and Williamson, A. E. (2021) Educational associations with missed GP appointments for patients under 35 years old: administrative data linkage study. BMC Medicine, 19, 219. (doi: 10.1186/s12916-021-02100-7) (PMID:34565364) (PMCID:PMC8474859)

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Abstract

Background: There is an evidence gap about whether levels of engagement with public services such as schools and health care affect people across the lifespan. Data on missed patient appointments from a nationally representative sample of Scottish general practices (GP) (2013–2016) were probabilistically linked to secondary school pupil data. We tested whether school attendance, exclusions (2007–2011) or lower educational attainment (2007–2016) was associated with an increased risk of missing general practice appointments. Methods: School attendance data were classified into quartiles of possible days attended for years we had data. School exclusions were derived as a categorical variable of ‘ever excluded’. Attainment data were categorised via the Scottish Credit and Qualifications Framework (SCQF) level 3 or 6; a cumulative measure of attainment on leaving school. The associations between school attendance, exclusions and attainment and risk of missing medical appointments were investigated using negative binomial models, offset by number of GP appointments made and controlling for potential confounders. Results: 112,534 patients (all aged under 35) had GP appointment and retrospective school attendance and exclusion data, and a subset of 66,967 also had attainment data available. Patients who had lower attendance, had been excluded from school or had lower educational attainment had an increased risk of missing GP appointments (all rate ratios > 1.40). Conclusions: This study provides the first evidence from a population-representative sample in a high-income country that increased numbers of missed appointments in health care are associated with reduced school attendance, higher levels of school exclusion and lower educational attainment. Insights into the epidemiology of missingness across public services can support future research, policy and practice that aim to improve healthcare, health outcomes and engagement in services.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Williamson, Dr Andrea and Fleming, Dr Michael and Wilson, Dr Philip and McQueenie, Dr Ross and Ellis, Mr David
Authors: McQueenie, R., Ellis, D. A., Fleming, M., Wilson, P., and Williamson, A. E.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:BMC Medicine
Publisher:BioMed Central
ISSN:1741-7015
ISSN (Online):1741-7015
Copyright Holders:Copyright © 2021 The Authors
First Published:First published in BMC Medicine 19: 219
Publisher Policy:Reproduced under a Creative Commons License

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
171964Investigating the importance of serial missed appointments in the NHS: a linkage pathfinder project of general practice, health, social care and education data.Ross McQueenieOffice of the Chief Scientific Adviser (CSO)CZH/4/1118HW - Robertson Centre