title: Factors associated with non-attendance in a general practice super clinic population in regional Australia: A retrospective cohort study.
abstract: BACKGROUND
  Non-attendance at medical appointments is associated with increased patient morbidity and is a significant drain on health service resources. Australian studies have focused on secondary healthcare settings, screening, and interventions to reduce non-attendance.
  
  
  OBJECTIVE
  To explore factors associated with non-attendance in a regional primary care setting.
  
  
  METHODS
  A retrospective cohort of all patients with a scheduled appointment between October 2011 and October 2013 at a regional, primary care clinic providing medical and allied health services in a region of New South Wales (NSW) serving a large Aboriginal population (10.7 per cent). Using multivariate logistic regression, non-attendance was regressed on a range of covariates, including number of appointments per person, gender and ethnicity, and day of the week.
  
  
  RESULTS
  The overall proportion of missed appointments was 7.6 per cent. Risk factors for non-attendance were day of the week [Mondays (8.1 per cent), Fridays (8.0 per cent), and Thursdays (7.9 per cent), (χ2(4)= 20.208, p<0.0005], having fewer scheduled appointments [≤5 appointments resulted in 19.1 per cent greater risk of failure to attend (FTA) (95% CI: 11-28%)]; Aboriginality (OR=4.022, 95% CI: 3.263, 4.956), and female gender (OR=1.077; 95% CI 1.024, 1.132). There was a trend toward an interaction between gender and Aboriginality, with Aboriginal females being the group most likely to miss appointments (OR=1.272, 95% CI: 0.949, 1.705).
  
  
  CONCLUSIONS
  This is the largest study of non-attendance in an Australian primary healthcare setting. While not a typical setting, the study had the advantage of a large, mixed population. The suggested high rates of non-attendance by Aboriginal females have potentially important policy implications.
authors.affiliation: School of Health and Human Sciences, Southern Cross University, Lismore, Australia.
authors.forename: Susan
authors.initials: S
authors.lastname: Nancarrow
authors.affiliation: School of Health and Human Sciences, Southern Cross University, Lismore, Australia.
authors.forename: Joanne
authors.initials: J
authors.lastname: Bradbury
authors.affiliation: School of Health and Human Sciences, Southern Cross University, Lismore, Australia.
authors.forename: Catherine
authors.initials: C
authors.lastname: Avila
keywords: Aboriginal; Non-attendance; super clinic