Research into the healthcare journey shows that patients who miss appointments with their GP are also less likely to attend hospital outpatient appointments.
Patients who missed more than two GP appointments (on average) per year, were at least three times more likely to miss outpatient appointments compared to those who missed no GP appointments.
Missingness from outpatient mental health services was especially high and it was also associated with ‘irregular discharge’ from in-patient care.
However, the researchers were surprised to find that patients who miss GP appointments do not use Emergency Departments instead.
“There’s often a belief that people who miss GP appointments must be clogging up A&E departments, but that’s not what this research shows,” said Dr David Ellis from the University of Bath’s School of Management.
“Missing multiple health care appointments may be linked to other factors including frailty, neurodevelopmental problems such as attention-deficit/hyperactivity disorder, neurodegenerative disease or psychological trauma. These factors individually or in combination may impact a person’s ability to organise, attend, or follow through on offers of care and require further research.”
The study, carried out by the Universities of Bath, Glasgow and Aberdeen examined over half a million patients’ appointment histories in Scotland over a three-year period from September 2013 to September 2016.
A previous research paper from the same team demonstrated links between missed GP appointments and early death, and received a Research Paper of the Year award from the Royal College of General Practitioners.
“This research pre-dates Covid times- however it’s a very pertinent reminder that as we attempt to reconfigure acute services there is not a level playing field in terms of engaging patients in that recovery,” said Dr Andrea Williamson, the study’s principal investigator from the University of Glasgow.
“Because patients have a much higher risk of early death, identifying patients at higher risk of missingness and taking steps to ensure patients attend should be part of the recovery strategy.
“Missingness in healthcare often focuses on what it means for a service, particularly in terms of financial expense, however our work suggests that missed appointments have serious impacts for patients.
“Policymakers, health service planners and clinicians should consider the role and contribution of ‘missingness’ in health care to improving patient safety and care.”
Missingness in health care: Associations between hospital utilization and missed appointments in general practice. A retrospective cohort study is published in PLOS ONE https://doi.org/10.1371/journal.pone.0253163