Why patients miss follow-up appointments: a prospective control-matched study.
OBJECTIVE
To investigate missed appointments in a South African tertiary hospital.


METHODS
Prospective, descriptive series with controls.


METHODS
The ENT/Oncology clinic at Tygerberg Academic Hospital, South Africa.


METHODS
305 patients with a head and neck malignancy who had follow-up appointments over 4 consecutive months between June and September 2006. A control group of 31 patients who attended the clinic was recruited in September 2006.


METHODS
Analysis of the clinic attendance statistics to identify patients who missed follow-up appointments followed by a file review and interview of these patients. The results were compared with a control group.


METHODS
1) Incidence rate of failure to attend follow-up. 2) Causative factors.


RESULTS
51 (17%) booked patients missed their appointments. Non-attenders were most likely to miss their follow-up between 6 and 12 months (17/31) after treatment. No correlations were found between diagnosis, disease stage and missed appointments. Reasons include: transport (19 responses), ill-health (6) and financial constraints (5). State transport was unavailable to almost two-thirds of the responders who cited transport as a problem.


CONCLUSIONS
The 17% missed appointment rate is largely due to transport constraints. The commonest time for patients to miss appointments is the 6-12 month follow-up period. The authors seek to identify patients at risk of missed appointments and suggest interventions to decrease this incidence.
Department of Otorhinolaryngology, Tygerberg Hospital/University of Stellenbosch Faculty of Health Sciences, Cape Town, South Africa. graeme@prometics.com
G
G
Van der Meer
J W
JW
Loock
D001071:Appointments and Schedules; D016022:Case-Control Studies; D006258:Head and Neck Neoplasms; D006801:Humans; D015994:Incidence; D010044:Outpatient Clinics, Hospital; D010342:Patient Acceptance of Health Care; D010349:Patient Compliance / Q000706:statistics & numerical data*; D010352:Patient Dropouts / Q000523:psychology* / Q000706:statistics & numerical data; D011446:Prospective Studies; D013019:South Africa