Lynn Nuti|Mark Lawley|Ayten Türkcan|Zhongxiang Tian|Lingsong Zhang|Karen Chang|Deanna Willis|Laura Sands
No-shows to primary care appointments: subsequent acute care utilization among diabetic patients
Purdue University West Lafayette|Purdue University West Lafayette|Northeastern University|Purdue University West Lafayette|Indiana University – Purdue University Indianapolis|Purdue University West Lafayette
abstract background patients noshow primary care appointments interrupt clinicians efforts provide continuity care prior literature reveals noshows among diabetic patients common purpose study assess whether noshows primary care appointments associated increased risk future emergency department ed visits hospital admissions among diabetics methods prospective cohort study conducted using data 8787 adult diabetic patients attending outpatient clinics associated medical center indiana outcomes examined hospital admissions ed visits 6 months 182 days following patients last scheduled primary care appointment andersengill extension cox proportional hazard model used assess risk separately hospital admissions ed visits adjustment made variables associated noshow status acute care utilization gender age race insurance comorbid status interaction utilization acute care service six months prior appointment noshow computed model results sixmonth rate hospital admissions following last scheduled primary care appointment 022 sd 083 noshows 014 sd 063 attended p lt 00001 noshow associated greater risk hospitalization among diabetics hospital admission prior six months among diabetic patients prior hospital admission noshowed 60 greater risk subsequent hospital admission hr 160 ci 117218 attended appointment sixmonth rate ed visits following last scheduled primary care appointment 056 sd 148 noshows 038 sd 105 attended p lt 00001 adjustment covariates noshow status significantly related subsequent ed utilization conclusions noshow primary care appointment associated increased risk hospital admission among diabetics recently hospitalized