PURPOSE: Outpatient hand clinic non-attendance is a pervasive issue, and identifying risk factors for clinic non-attendance can help inform strategies for addressing this problem. No study has evaluated risk factors for hand clinic non-attendance among emergency department (ED) patients at urban safety-net community hospitals, which are a common source of referrals for many hand providers.
METHODS: We conducted a one-year retrospective chart review of all ED patients at an urban safety-net community hospital for whom hand surgery consults were ordered in 2023. For patients who were deemed to require follow-up in hand clinic, bivariable and multivariable analyses were performed to identify demographic and consult-related factors associated with hand clinic non-attendance. P < 0.05 was considered significant for all analyses.
RESULTS: Of the 200 patients who required follow-up in our hand clinic, 129 (64.5%) attended their hand clinic appointment and 71 (35.5%) did not. On multivariable analysis, factors significantly associated with decreased likelihood of hand clinic attendance were being marginally housed (adjusted odds ratio (aOR) = 0.27, 95% confidence interval (CI): 0.11-0.63) and not having a primary care provider (aOR = 0.38, CI: 0.19-0.78). Factors significantly associated with increased likelihood of attendance included having a bone injury (aOR = 2.28, CI: 1.12-4.63), having a tendon injury (aOR = 7.83, CI: 1.64-37.48), or having undergone a nailbed repair (aOR = 6.24, CI: 1.28-30.38).
CONCLUSIONS: Among patients referred to an urban safety-net community-based hand clinic after presentation to the ED, hand clinic non-attendance is common. Various unique factors are significantly associated with increased or decreased likelihood of clinic attendance in this setting. These factors could be used to develop strategies for improving clinic attendance for similar practices moving forward.
Read the article: PubMed · Publisher (DOI)