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Objectives: Women's attendance to cervical cancer screening (CCS) is a major concern for healthcare providers in community. This study aims to use the various algorithms that can accurately predict the most barriers of women for nonattendance to CS. Design: The real‐time data were collected from women presented at OPD of primary health centers (PHCs). About 1046 women's data regarding attendance and nonattendance to CCS were included. In this study, we have used three models, classification, ensemble, and deep learning models, to compare the specific accuracy and AU‐ROC for predicting non‐attenders for CC. Results: The current model employs 22 predictors, with soft voting in ensemble models showing slightly higher specificity (96%) and sensitivity (93%) than weighted averaging. Bagging excels with the highest accuracy (98.49%), specificity (97.3%), and ideal sensitivity (100%) with an AUC of 0.99. Classification models reveal Naive Bayes with higher specificity (97%) but lower sensitivity (91%) than Logistic Regression. Random Forest and Neural Network achieve the highest accuracy (98.49%), with an AUC of 0.98. In deep learning, LSTM has an accuracy of 95.68%, higher specificity (97.60%), and lower sensitivity (93.42%) compared to other models. MLP and NN showed the highest AUC values of 0.99. Conclusion: Employing ensemble and deep learning models proved most effective in predicting barriers to nonattendance in cervical screening. [ABSTRACT FROM AUTHOR]

Abstract Background Hidradenitis suppurativa (HS) is associated with several comorbidities and significant impairment of quality of life. Moderate to severe HS patients have often prolonged treatment courses at various hospitals. We investigated various factors that may be related to missed follow‐up visits during prolonged treatment courses among HS outpatients. Objectives To highlight potential predictors for appointment absenteeism among HS patients. Methods During a 12‐month period at a university hospital dermatology outpatient clinic, absenteeism and related factors were obtained for each visit at the hospital. Results Out of 161 unique follow‐up visits during a 12‐month period at a university hospital dermatology outpatient clinic, 37 patients (23.0%) were absentees. Patients with non‐attendance were more likely to be males (p = 0.02). Patients who were on biologic treatment for HS were less likely to miss appointments (p = 0.06). Conclusions Our study showed that almost one in four hospital outpatients with HS fail to show up for their scheduled appointments. The data suggest an increased awareness of high risk of missed follow‐up visits during treatment of HS patients.

Nonattendance for cervical cancer screening is often understood in terms of a lack of 'appropriate' or 'correct' knowledge about the risks and prevention of the disease. Few studies have explored how lay persons—the users themselves—interpret and contextualise scientific knowledge about cervical cancer. In this study, we address the following research question: How is the epidemiology of cervical cancer and its prevention discussed among women who are late for cervical cancer screening in Norway? We completed nine focus group interviews (FGIs) with 41 women who had postponed cervical screening. The analyses were both inductive and explorative, aiming to unpack the complexity of lay understandings of cervical cancer. Interactive associations expressed in the FGIs reflected multiple understandings of aetiology and risk factors, screening, and interpretations of responsibility for acquiring cervical cancer. The term 'candidacy' was employed to provide an enhanced understanding of lay reasoning about the explanations and predictions of cervical cancer, as reflected in the FGIs. Both interpretations of biomedical concepts and cultural values were used to negotiate acceptable and nuanced interpretations of candidacy for cervical cancer. Uncertainties about risk factors for acquiring cervical cancer was an important aspect of such negotiations. The study's findings provide an in-depth understanding of the contexts in which screening may be rendered less relevant or significant for maintaining health. Lay epidemiology should not be considered inappropriate knowledge but rather as a productive component when understanding health behaviours, such as screening attendance. [ABSTRACT FROM AUTHOR]

Background: Nonattendance is common among patients suffering from delusional infestation (DI) with a risk factor for poorer patient outcomes. Objective: The aim of this study was to determine the incidence rate and predictors of nonattendance among patients presenting to a psychodermatology department with DI and the subsequent effect on the success of prescribing new antipsychotics. Methods: Data of 265 patients were reviewed of the Amsterdam UMC, the Erasmus University Medical Center, the Royal London Hospital, and the Liverpool School of Tropical Medicine between January 2008 and October 2019. Results: We observed that among the patients who attended the first consultation, 57% (n = 144) did not attend their second visit. Recreational drug use was significantly higher in the nonattendance group compared to the attendance group (25% against 18%). Patients who had a history of previously prescribed antipsychotics at the time of the first consultation were less likely to get prescribed antipsychotics from the psychodermatology departments for DI; however, prescribing antipsychotic drugs by the psychodermatology department did not influence nonattendance significantly. Conclusions: People suffering from DI are at high risk of nonattendance, even in specialist settings. Patients with current illicit drug use and younger patients are particularly at risk of this. [ABSTRACT FROM AUTHOR]

Abstract Background Nonattendance is a common problem worldwide. Important factors for nonattendance are a queue or the waiting time until the planned service. Aims The aims of this study were to identify the reasons for nonattendance to planned consultations, assess the waiting time from registration to access to an outpatient specialist consultation, and identify the associations between the reasons for nonattendance and the waiting time until the planned outpatient specialist consultation. Methods A cross-sectional study based on a phone questionnaire was conducted among patients not attending a planned consultation at the outpatient department of the Lithuanian University of Health Sciences Kaunas Hospital in Kaunas, Lithuania. A total of 972 phone calls were made, and 389 telephone surveys were completed. Results The mean respondents’ waiting time until the planned outpatient consultation was 15.13 ± 10 days. The highest proportion of nonattendance was observed when the wait time was between 6 and 17 days. More often, the patients did not attend the planned outpatient consultation due to worsened health status (24.69%), unidentified personal problems (14.91%), work-related problems (13.62%) and being unaware about the appointment (11.82%). A longer waiting time was significantly associated with the following reasons for nonattendance: work-related problems, health problems solved at another health care institution, unidentified personal problems and unknown reasons for nonattendance. The highest proportions of nonattending patients had consultations registered with neurologists (17.0%), traumatologists (11.3%) and cardiologists (10.5%). Conclusions Patients did not identify the long waiting time until outpatient specialist consultation among the main reasons for nonattendance. The issue of waiting time is not an important aspect of nonattendance.

This study examined patient and appointment factors as predictors of nonattendance in addiction mental health services. Data were collected from the electronic files of 7,641 patients treated for a substance use disorder in outpatient clinics of an addiction mental health organization in the Netherlands. Negative binomial regression analyses revealed that cocaine use, poly substance use, limitations in interpersonal functioning, presence of anxiety disorder and cluster C personality disorder, age, level of education, source of income, and planning consistency were associated with nonattendance. [ABSTRACT FROM AUTHOR]

Introduction: Outpatient appointment nonattendance (NA) represents a public health problem, increasing the risk of unfavorable health-related outcomes. Although NA is significant among older adults, little is known regarding its correlates. This study aimed to identify the correlates (including several domains from the geriatric assessment) of single and repeated NA episodes in a geriatric medicine outpatient clinic, in general and in the context of specific comorbidities. Methods: This is a cross-sectional study including data from 3,034 older adults aged ≥60 years with ≥1 scheduled appointments between January 1, 2016, and December 31, 2016. Appointment characteristics as well as sociodemographic, geographical, and environmental information were obtained. Univariate and multivariate multinomial regression analyses were carried out. Results: The mean age was 81.8 years (SD 7.19). Over a third (37.4%) of participants missed one scheduled appointment, and 14.4% missed ≥2. Participants with a history of stroke (OR 1.336, p = 0.041) and those with a greater number of scheduled appointments during the study time frame (OR 1.182, p < 0.001) were more likely to miss one appointment, while those with Parkinson's disease (OR 0.346, p < 0.001), other pulmonary diseases (OR 0.686, p = 0.008), and better functioning for activities of daily living (ADL) (OR 0.883, p < 0.001) were less likely to do so. High socioeconomic level (OR 2.235, p < 0.001), not having a partner (OR 1.410, p = 0.006), a history of fractures (OR 1.492, p = 0.031), and a greater number of scheduled appointments (OR 1.668, p < 0.001) increased the risk of repeated NA, while osteoarthritis (OR 0.599, p = 0.001) and hypertension (OR 0.680, p = 0.002) decreased it. In specific comorbidity populations (hypertension, type 2 diabetes mellitus, and cancer), better ADL functioning protected from a single NA, while better mobility functioning protected from repeated NA in older patients with hypertension and cancer. Discussion/Conclusion: Identifying geriatric factors linked to an increased probability of NA may allow one to anticipate its likelihood and lead to the design and implementation of preventive strategies and to an optimization of the use of available health resources. The impact of these factors on adherence to clinical visits requires further investigation. [ABSTRACT FROM AUTHOR]

Objectives: Missed appointments negatively affect patients, providers, and health systems. This study aimed to (1) quantify the percentage of missed appointments across 14 pediatric subspecialties in a tertiary-care children's hospital and (2) identify patient characteristics associated with missed appointments in those subspecialties. Methods: We extracted patient characteristics from 267,151 outpatient appointments, between January 1, 2013, and December 31, 2018, across 14 subspecialty clinics. Medical complexity was categorized using the Pediatric Medical Complexity Algorithm. The primary outcome was appointment nonattendance. Cancellations, imaging/laboratory visits, patients older than 18 years, and duplicate visits were excluded. Characteristics associated with nonattendance were analyzed with chi-square tests and included in the multivariable model if p <.1. Missing data were addressed using random forest imputation, and assuming data were "missing at random." Variables were considered statistically significant if p <.05. Results: Of the 128,117 scheduled appointments analyzed, 23,204 (18.1%) were missed. In the multivariable model, clinical nutrition had the greatest subspecialty odds of missed appointments, whereas cardiology had the lowest. Patient characteristics most strongly associated with missed appointments were public insurance, history of >2 missed appointments, appointment lead time, lesser medical complexity, Black race/ethnicity, and fewer medications. Conclusions: Clinical characteristics including lesser medical complexity and fewer medications are associated with missed appointments in pediatric subspecialties. [ABSTRACT FROM AUTHOR]

Nonattendance for cervical cancer screening is often understood in terms of a lack of ‘appropriate’ or ‘correct’ knowledge about the risks and prevention of the disease. Few studies have explored how lay persons—the users themselves—interpret and contextualise scientific knowledge about cervical cancer. In this study, we address the following research question: How is the epidemiology of cervical cancer and its prevention discussed among women who are late for cervical cancer screening in Norway? We completed nine focus group interviews (FGIs) with 41 women who had postponed cervical screening. The analyses were both inductive and explorative, aiming to unpack the complexity of lay understandings of cervical cancer. Interactive associations expressed in the FGIs reflected multiple understandings of aetiology and risk factors, screening, and interpretations of responsibility for acquiring cervical cancer. The term ‘candidacy’ was employed to provide an enhanced understanding of lay reasoning about the explanations and predictions of cervical cancer, as reflected in the FGIs. Both interpretations of biomedical concepts and cultural values were used to negotiate acceptable and nuanced interpretations of candidacy for cervical cancer. Uncertainties about risk factors for acquiring cervical cancer was an important aspect of such negotiations. The study’s findings provide an in-depth understanding of the contexts in which screening may be rendered less relevant or significant for maintaining health. Lay epidemiology should not be considered inappropriate knowledge but rather as a productive component when understanding health behaviours, such as screening attendance.

Background:  Nonattendance is a common problem worldwide. Important factors for nonattendance are a queue or the waiting time until the planned service.Aims: The aims of this study were to identify the reasons for nonattendance to planned consultations, assess the waiting time from registration to access to an outpatient specialist consultation, and identify the associations between the reasons for nonattendance and the waiting time until the planned outpatient specialist consultation.Methods: A cross-sectional study based on a phone questionnaire was conducted among patients not attending a planned consultation at the outpatient department of the Lithuanian University of Health Sciences Kaunas Hospital in Kaunas, Lithuania. A total of 972 phone calls were made, and 389 telephone surveys were completed.Results: The mean respondents' waiting time until the planned outpatient consultation was 15.13 ± 10 days. The highest proportion of nonattendance was observed when the wait time was between 6 and 17 days. More often, the patients did not attend the planned outpatient consultation due to worsened health status (24.69%), unidentified personal problems (14.91%), work-related problems (13.62%) and being unaware about the appointment (11.82%). A longer waiting time was significantly associated with the following reasons for nonattendance: work-related problems, health problems solved at another health care institution, unidentified personal problems and unknown reasons for nonattendance. The highest proportions of nonattending patients had consultations registered with neurologists (17.0%), traumatologists (11.3%) and cardiologists (10.5%).Conclusions: Patients did not identify the long waiting time until outpatient specialist consultation among the main reasons for nonattendance. The issue of waiting time is not an important aspect of nonattendance. [ABSTRACT FROM AUTHOR]

Background: Inflammatory bowel disease (IBD), which can have a considerable effect on quality of life, productivity and performance, is typically diagnosed during periods of life in which patients have academic and career-related responsibilities. Objective: The objective of the study was to determine the effect of IBD symptoms on work and school absenteeism in patients from Saudi Arabia. Patients and Methods: This cross-sectional survey included patients diagnosed with IBD, aged >8–60 years, at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. The validated 32-question IBD quality-of-life questionnaire was used to elicit information regarding quality of life and another 9-question validated questionnaire was used to assess work and school absenteeism. A logistic regression analysis was used to identify possible determinants of absenteeism. Results: A total of 123 IBD patients were included, with a 1:1 male-to-female ratio. The median age at presentation was 26 years (range: 8–59 years), 56.9% had Crohn's disease, and 43.1% had ulcerative colitis. Further, 58 (47.2%) were employed, 49 (39.8%) were students and 16 (13%) were unemployed. Forty-seven (43.9%) participants reported absenteeism: 26 were employees (55.3%) and 21 were students (44.7%). A binary logistic regression analysis identified IBD subtype (P = 0.006) and the presence of perianal disease (P = 0.028) as clinical predictors for absenteeism from school or work. A feeling of abdominal pain (P = 0.015), fatigue (P = 0.015) and difficulty taking part in social engagements (P < 0.001) were also significantly associated with absenteeism. Conclusions: A sizeable proportion of the participants reported absenteeism owing to the effects of IBD. IBD subtype, perianal disease, presence of ongoing abdominal pain, fatigue and difficulty in social engagement were strongly associated with nonattendance.

This paper shows a study about nonattendance to medical appointments in the Colombian health system to determine which strategies have the greatest effect on the response variable (nonattendance) of scheduled medical appointments. Three factors were considered (calling the patient, reconfirming on the eve of the appointment, confirming understanding of the procedure), each with two or three levels randomly selected from a population. Two replicates were taken for each combination of treatments. The experimental runs were done randomly to guarantee the absence of bias in data collection. With the above, a total of 180 experimental runs were carried out. This study aims to determine the factors that influence the population when they do not attend their medical appointments to propose a strategy that reduces this phenomenon. A design of experiments (DoE) was performed, specifically a completely randomized design (CRD) and a 3k factorial design. [ABSTRACT FROM AUTHOR]

This paper shows a study about nonattendance to medical appointments in the Colombian health system to determine which strategies have the greatest effect on the response variable (nonattendance) of scheduled medical appointments. Three factors were considered (calling the patient, reconfirming on the eve of the appointment, confirming understanding of the procedure), each with two or three levels randomly selected from a population. Two replicates were taken for each combination of treatments. The experimental runs were donerandomly to guarantee the absence of bias in data collection. With the above, a total of 180 experimental runs were carried out. This study aims to determine the factors that influence the population when they do not attend their medical appointments to propose a strategy that reduces this phenomenon. A design of experiments (DoE) was performed, specifically a completely randomized design (CRD) and a 3k factorial design

Background: Nonattendance at scheduled outpatient visits among children with asthma has been associated with an increased risk of acute asthma events and increased health care expenses. Specific risk factors for nonattendance have been suggested, but a comprehensive overview is lacking., Objective: To investigate risk factors for nonattendance among children with asthma and assess whether nonattendance associates with acute events through a systematic review and meta-analysis., Methods: The study (PROSPERO: CRD42023471893) was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines using the PubMed, Ovid MEDLINE, Embase, ClinicalTrials.gov, and Cochrane Library databases and search terms "asthma/wheeze," "child," and "nonattendance." Original peer-reviewed studies in English were included and evaluated for risk of bias using the Newcastle Ottawa scale. A meta-analysis was performed for all risk factors. Finally, we analyzed whether nonattendance was associated with the risk of acute events., Results: A total of 17 studies encompassing 27,023 children with asthma were included. The meta-analysis was performed on 11 eligible studies, with 25,948 children, and identified the following risk factors for nonattendance; teenage versus preteen (odds ratio [OR] 1.26; 95% confidence interval [95% CI] 1.06-1.49; P < .01), non-White versus White ethnicity (OR 1.51; 95% CI 1.04-2.18; P = .03) and lower disease severity (OR 1.41; 95% CI 1.13-1.77; P < .01). There were no significant findings in the meta-analysis for insurance status, atopy, sex, or rural residence. Nonattendance associated with an increased risk of acute asthma events (OR 1.11; 95% CI 1.07-1.16; P < .01)., Conclusions: This systematic review and meta-analysis identified specific risk factors to facilitate the development of a strategy against nonattendance for pediatric patients with asthma. This is particularly important given nonattendance being associated with an increased risk of acute asthma., (Copyright © 2024 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.)

Objectives: Nonattendance of appointments in outpatient clinics results in many adverse effects including inefficient use of valuable resources, wasted capacity, increased delays, and gaps in patient care. This research presents a modeling framework for designing positive incentives aimed at decreasing patient nonattendance.Methods: We develop a partially observable Markov decision process (POMDP) model to identify optimal adaptive reinforcement schedules with which financial incentives are disbursed. The POMDP model is conceptually motivated based on contingency management evidence and practices. We compare the expected net profit and trade-offs for a clinic using data from the literature for a base case and the optimal positive incentive design resulting from the POMDP model. To accommodate a less technical audience, we summarize guidelines for reinforcement schedules from a simplified Markov decision process model.Results: The results of the POMDP model show that a clinic can increase its net profit per recurrent patient while simultaneously increasing patient attendance. An increase in net profit of 6.10% was observed compared with a policy with no positive incentive implemented. Underlying this net profit increase is a favorable trade-off for a clinic in investing in a targeted contingency management-based positive incentive structure and an increase in patient attendance rates.Conclusions: Through a strategic positive incentive design, the POMDP model results show that principles from contingency management can support decreasing nonattendance rates and improving outpatient clinic efficiency of its appointment capacity, and improved clinic efficiency can offset the costs of contingency management. [ABSTRACT FROM AUTHOR]

The extant literature is bereft of evidence about the detrimental outcomes of the COVID-19 pandemic on hotel employees' mental health (MH) and work and nonwork outcomes. Therefore, our paper examines MH problems as a mediator of the effect of COVID-19 as a stressor on propensity to be late for work (PLW) and absenteeism, as well as life satisfaction (LS). One hundred and fifty-one employees in two national five-star hotels in Turkey completed Web-based surveys. The previously mentioned linkages were gauged via structural equation modelling. Study results reveal that employees who are at risk of getting infected by COVID-19 are beset with MH problems at elevated levels. These employees in turn exhibit PLW and absences from work and display low levels of LS. The results further demonstrate that the threat of COVID-19 triggers employees' absenteeism. Our paper provides theoretical implications and recommendations for managers in the hospitality industry. [ABSTRACT FROM AUTHOR]

Objective: Our objectives were to determine the no-show and nonattendance rate for an outpatient academic otolaryngology practice, to identify patient and systemic factors associated with nonattendance, and to evaluate the impact that the COVID-19 pandemic had on the rate of nonattendance., Methods: This is a retrospective review of the Epic practice management and billing reports from all scheduled outpatient visits at a multi-physician, academic, general, and sub-specialty otolaryngology practice from January 2019 to December 2021., Results: Over three years, 121,347 clinic visits were scheduled in the otolaryngology practice. The overall nonattendance rate was 18.3%. A statistically significant increase in nonattendance was noted during the COVID-19 pandemic (16.8% vs. 19.8%, p < 0.001). The rate of nonattendance in patients of younger age (under 18 years) (p <0.001), female gender (p=0.03), afternoon appointments (p=0.04), and extended time between the day of scheduling and the day of appointment (p <0.001) increased. Head and neck clinics were found to have the lowest nonattendance rates, while pediatric otolaryngology clinics had the highest (12.6% vs. 21.3%). On multivariate regression, younger age (p < 0.001), female gender (p=0.01), afternoon appointments (p< 0.001), and online self-scheduling (p< 0.001) were significantly associated with nonattendance., Conclusions: Both patient and appointment-related factors were found to impact rates of nonattendance in this academic otolaryngology practice. In this study, young age, female gender, afternoon appointments, and online self-scheduling were associated with increased nonattendance. In addition, the COVID-19 pandemic significantly impacted no-show rates across all otolaryngologic subspecialties., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Yuhan et al.)

Les méthodes combinées d'apprentissage pourraient être une réponse à l'absentéisme des étudiants. Un enseignement facultatif, associant e-learning/séances transversales présentielles, a été implémenté à l'université Paris-Diderot pour l'enseignement du module réanimation/urgences au cours de l'année 2018/2019. L'objectif de ce travail était d'évaluer cet enseignement. Questionnaire soumis aux 388 étudiants de DFASM3 présents à l'épreuve de validation du module réanimation/urgences. L'assiduité à une modalité d'enseignement était définie par le suivi de plus de la moitié de cet enseignement. La corrélation entre participation aux enseignements/note à l'examen a été étudiée. Au total, 358/388 (92 %) étudiants ont participé à cette enquête. Un quart des étudiants (88/321 — 25 %) se déclaraient habituellement assidus aux cours magistraux traditionnels. Concernant l'enseignement combiné, 210/317 (67 %) étudiants se déclaraient assidus aux cours en e-learning et 84/321 (27 %) se déclaraient assidus aux séances transversales interactives. La répartition des étudiants selon leur assiduité aux séances transversales et/ou e-learning était significativement différente (p < 0,01). Il existait une corrélation significative (p < 0,001) entre l'assiduité au e-learning et la note obtenue à l'examen facultaire. Néanmoins cette corrélation était également observée pour ces étudiants dans un autre module enseigné traditionnellement. Les étudiants se déclaraient globalement très satisfaits (309/315 — 98 %) par cette nouvelle modalité d'enseignement et 297/318 (93 %) souhaitaient son extension à l'ensemble du second cycle. L'utilisation de méthodes combinées d'apprentissage a permis de toucher plus d'étudiants que les enseignements traditionnels et de recentrer l'université dans son rôle de transmission du savoir. Blended-learning methods could be a response to student nonattendance. Non-compulsory teaching combining e-learning/interactive face-to-face sessions has been implemented at Paris-Diderot Medical School for the teaching of intensive care and emergency medicine during the 2018/2019 university period. The aim of the study was to assess this newly-implemented blended teaching. Questionnaire submitted to the 388 DFASM3 medical students present at the faculty exam of intensive care/emergency medicine. Attendance at a teaching modality was defined by the follow-up of more than half of this teaching modality. Correlations between attendance at e-learning and/or interactive face-to-face sessions, and grade were performed. A total of 358/388 (92%) students participated in this survey. A quarter of the students (88/321 – 25%) reported they usually attended at traditional lectures. Regarding blended-learning, 210/317 (67%) students reported having attended at e-learning courses and 84/321 (27%) attended at interactive face-to-face sessions. The distribution of students according to their attendance at e-learning and/or interactive face-to-face sessions was significantly different (P < 0.01). There was a significant correlation (P < 0.001) between attendance at e-learning and grade obtained at the faculty exam. Nevertheless, this correlation was also found for these students in another course taught traditionally. Overall, 309/315 (98%) students were satisfied with the blended teaching, 297/318 (93%) wanted its extent to the whole medical school's curriculum. The use of combined learning methods reached more students than traditional teachings and allowed the University to focus on its role of knowledge transfer. [ABSTRACT FROM AUTHOR]

Background: Approximately one-third of patient appointments in Danish health care result in failures, leading to patient risk and sizable resource waste. Existing interventions to alleviate no-shows often target the patients. The underlying reason behind these interventions is a view that attendance or nonattendance is solely the patient's problem. However, these interventions often prove to be ineffective and can perpetuate social biases and health inequalities, leaving behind patients who are more vulnerable or disadvantaged (in terms of social, economical, and linguistic factors, etc). A more holistic understanding of no-shows is needed to optimize processes, reduce waste, and support patients who are vulnerable., Objective: This study aims to gain a deep and more comprehensive understanding of the causes, mechanisms, and recurring patterns and elements contributing to nonattendance at Danish hospitals in the Region of Southern Denmark. It emphasizes the patient perspective and analyzes the relational and organizational processes surrounding no-shows in health care. In addition, the study aims to identify effective communicative strategies and organizational processes that can support the development and implementation of successful interventions., Methods: The study uses mixed quantitative-qualitative methods, encompassing 4 analytical projects focusing on nonattendance patterns, patient knowledge and behavior, the management of hospital appointments, and in situ communication. To address the complexity of no-shows in health care, the study incorporates various data sources. The quantitative data sources include the electronic patient records, Danish central registries, Danish National Patient Registry, and Register of Medicinal Product Statistics. Baseline characteristics of patients at different levels are compared using chi-square tests and Kruskal-Wallis tests. The qualitative studies involve observational data, individual semistructured interviews with patients and practitioners, and video recordings of patient consultations., Results: This paper presents the protocol of the study, which was funded by the Novo Nordisk Foundation in July 2022. Recruitment started in February 2023. It is anticipated that the quantitative data analysis will be completed by the end of September 2023, with the qualitative investigation starting in October 2023. The first study findings are anticipated to be available by the end of 2024., Conclusions: The existing studies of nonattendance in Danish health care are inadequate in addressing relational and organizational factors leading to hospital no-shows. Interventions have had limited effect, highlighting the Danish health care system's failure to accommodate patients who are vulnerable. Effective interventions require a qualitative approach and robust ethnographic data to supplement the description and categorization of no-shows at hospitals. Obtaining comprehensive knowledge about the causes of missed patient appointments will yield practical benefits, enhancing the safety, coherence, and quality of treatment in health care., International Registered Report Identifier (irrid): PRR1-10.2196/46227., (©Daria Schwalbe, Morten Sodemann, Maria Iachina, Bente Mertz Nørgård, Nina Høy Chodkiewicz, Jette Ammentorp. Originally published in JMIR Research Protocols (https://www.researchprotocols.org), 03.11.2023.)

Background: Access to dermatologists is low among Medicaid-insured patients. Higher clinic nonattendance among Medicaid-insured patients might affect provider decisions to accept these patients.Objective: To determine the effect of different scheduling policies on the attendance among children seen at a pediatric dermatology clinic.Methods: In this retrospective review, we compared nonattendance among children for 3 different scheduling policies implemented over 3 consecutive years. The scheduling policies used were a first-available open scheduling policy, a 2-week in advance scheduling policy, and a 4-week in advance scheduling policy. Subset analyses were performed by clinic location and insurance type.Results: The interval between scheduling and appointment date was directly related to nonattendance rates; rates were higher for Medicaid-insured than privately insured patients. Open scheduling was associated with a 37% nonattendance rate for Medicaid-insured patients and 18% nonattendance rate for privately insured patients. A 4-week in advance scheduling policy significantly decreased the nonattendance rate to 19% among Medicaid-insured and 7% among privately insured patients. A 2-week in advance policy further decreased the nonattendance rate to 11% among Medicaid-insured patients and 4% among privately insured patients.Limitations: This is a retrospective study, and same-day cancellations were not tracked.Conclusion: Decreasing the time interval between scheduling and appointment dates can significantly decrease nonattendance. This strategy might help dermatologists incorporate more Medicaid-insured patients into their practices. [ABSTRACT FROM AUTHOR]

Aim: To identify the rate and associated factors of loss to post‐partum follow‐up among adolescent mothers. Methods: A matched case–control study was conducted among Thai adolescents who gave birth between January 2011 and December 2016 and were scheduled for a 6‐week post‐partum visit. Cases (n = 568) included mothers who did not return for follow‐up whereas controls (n = 568) were mothers who attended a post‐partum visit. Cases were matched with controls according to age group and date of delivery. Results: During the study period, 2335 Thai adolescent mothers were scheduled for a post‐partum visit. Of these, 568 mothers (24.3%) did not return for post‐partum care. The strongest predictor for loss to post‐partum follow‐up was inadequate number of antenatal visits (adjusted odds ratio [aOR] 2.14, 95% confidence interval [CI] 1.51–3.04), followed by being single/separated/divorced (aOR 1.58, 95% CI 1.08–2.29) and lower level of education (aOR 1.57, 95% CI 1.14–2.17). Being a student was a positive factor associated with post‐partum visit attendance (aOR 0.57, 95% CI 0.40–0.80). Conclusion: Approximately one quarter of adolescent mothers did not attend a post‐partum visit. Three independent characteristics associated with loss to post‐partum follow‐up included inadequate number of antenatal visits, being single/separated/divorced and lower level of education. Being a student was positively associated with post‐partum visit attendance. Intensive intervention programs including using technology to remind post‐partum women, home visits and counseling during the immediate post‐partum period should be implemented to increase the post‐partum attendance rate among adolescent mothers. [ABSTRACT FROM AUTHOR]

Background: Nonattendance to clinical appointments is a global problem appreciated by clinicians with an ambulatory presence. There are few reports of nonattendance in otolaryngology clinics, and no reports on nonattendance for a single otolaryngology subspecialty. Objective: To describe the no-show population in rhinology clinics. Methods: A retrospective chart review was performed involving rhinology clinics from 2 academic medical centers in the United States. All patients who either attended their clinic appointment(s) or did not attend without previously cancelling from June 2016 to May 2017 were included. Data collected included patient demographics, appointment status, season and time of visit, insurance status, type of visit (new vs established), and provider seen. Results: There were 2791 clinical appointments evaluated over a 12-month period at 2 rhinology clinics involving 4 fellowship-trained rhinologists. Ninety-two percent of patients kept their appointments, while 8% did not. Sex, season of visit, time of visit (am vs pm), type of visit, provider sex, provider location, or provider's experience (<10 years vs ≥10 years) were not associated with patient's attendance status. Univariate analysis showed that patient's age ≤50 (P =.001) and primary insurance type (P <.001) were associated with nonattendance. Medicaid as the primary insurance type was associated with clinic nonattendance. Multivariable analysis showed that age ≤ 50 years, odds ratio (OR) 1.62 (95% confidence interval [CI] 1.14–2.30), P =.007, and primary insurance type (Medicaid: OR 3.75 [95% CI 2.58–5.45], P <.001) remained significant predictors of nonattendance. Conclusion: Patients younger than 50 years and patients with Medicaid as the primary insurance types are associated with risk of missing rhinology clinic appointments. As a subspecialty, delivery of timely care and clinical efficiency could be improved by interventions directed toward improving attendance among this population. [ABSTRACT FROM AUTHOR]

Clients' nonattendance in therapy poses a significant threat to the effective delivery of mental health services at university counseling centers. As such, researchers have investigated processes related to clients' nonattendance in an effort to increase treatment utilization and treatment outcomes. However, there is a paucity of research testing the impact of the therapist on clients' nonattendance patterns. Additionally, it is unknown whether therapists vary in the nonattendance of their racial/ethnic minority (REM) and White clients. Therefore, the present study sought to identify therapist effects in client nonattendance rates, and examine between-therapist disparities in REM and White clients' nonattendance patterns. Data for this study consisted of 275 REM and 341 White clients seen by 21 therapists at a large university counseling center. Results indicated that therapists accounted for 14% of the variability in clients' nonattendance. Additionally, therapist effects in nonattendance due to clients' REM status were identified, suggesting that therapists are a significant source of racial/ethnic disparities in clients' nonattendance. REM clients' nonattendance rates were higher compared to White clients for some therapists, but not others. Clinical implications and future research are discussed. [ABSTRACT FROM AUTHOR]

To evaluate the effectiveness of patient-chosen appointment reminder methods (phone call, e-mail, or SMS text) in reducing no-show rates. Materials and Methods: This was a retrospective case study that determined the correlation between patient-chosen appointment reminder methods and no-show rates in a private orthodontic practice. This study was conducted in a single office location of a multioffice private orthodontic practice using data gathered in 2015. The subjects were patients who self-selected the appointment reminder method (phone call, e-mail, or SMS text). Patient appointment data were collected over a 6-month period. Patient attendance was analyzed with descriptive statistics to determine any significant differences among patient-chosen reminder methods. Results: There was a total of 1193 appointments with an average no-show rate of 2.43% across the three reminder methods. No statistically significant differences (P¼.569) were observed in the no-show rates between the three methods: phone call (3.49%), e-mail (2.68%), and SMS text (1.90%). Conclusions: The electronic appointment reminder methods (SMS text and e-mail) had lower noshow rates compared with the phone call method, with SMS text having the lowest no-show rate of 1.90%. However, since no significant differences were observed between the three patient-chosen reminder methods, providers may want to allow patients to choose their reminder method to decrease no-shows. [ABSTRACT FROM AUTHOR]

Aims and objectives: This study explored nonattendees’ perspectives on a screening programme for cardiovascular disease and diabetes mellitus among women aged 60–77 years. Background: Nonattendance in screening is a common concern and has been associated with increased morbidity and mortality. Whether nonattendees need targeted information to participate in screening is unknown. Thus, it is important to explore the reasons for nonattendance, particularly as nonattendees’ perspectives have not been fully explored. Design: An interview study. Methods: The data were obtained through semistructured interviews with 10 women sampled from a population who declined to participate in a women's screening programme for cardiovascular disease and diabetes mellitus. Additionally, reflective notes on the interview context were documented. The data were collected in 2013. Kvale and Brinkmann's method for data analysis was applied. Results: All informants found the screening offer personally irrelevant, but this belief was changeable. The informants’ perceptions of screening were based on subjective health and risk beliefs, personal knowledge of diseases and the screening programme, and distrust in the healthcare system. Conclusion: Personal experiences, beliefs and self‐protective strategies influence individuals’ subjective interpretations of a screening programme's relevance. The perception that screening is irrelevant seems to be rooted in nonattendees’ personal health‐related assessment and knowledge. Consequently, whether nonattendance is determined by an informed decision is questionable. Negative experiences with the healthcare system led to hesitation towards screening in general. Relevance to clinical practice: This study is relevant to healthcare workers as well as decision‐makers from a screening and preventive perspective. The findings highlight important issues that should be addressed to encourage invitees to accept screening invitations and to facilitate informed decision‐making about screening participation. [ABSTRACT FROM AUTHOR]

Aims and objectives To explore what reasons do nonattenders and noncompleters give for their patterns of participation or nonparticipation in cardiac rehabilitation programmes and how future uptake could be enhanced. Background Cardiac rehabilitation is a cost-effective clinical intervention designed for adults with acute coronary syndrome. Despite evidence from meta-analyses demonstrating that cardiac rehabilitation programmes facilitate physical and psychological recovery from acute coronary syndrome, only 20-50% of eligible patients attend Phase III outpatient programmes. Design A qualitative study using thematic analysis. Method Within the context of a larger mixed-method study, acute coronary syndrome patients were recruited between 2012-2014 from three hospitals in Scotland. Of 214 patients who consented to enrol in the main study, a purposive subsample of 25 participants was recruited. Semi-structured interviews were conducted and analysed using thematic analysis. Results Three major influences of participation were identified: (1) personal factors, (2) programme factors and (3) practical factors. In addition, valuable suggestions for future programme modifications were provided. A significant barrier to attending cardiac rehabilitation programmes is that participants perceived themselves to be unsuitable for the programme alongside a lack of knowledge and/or misconceptions regarding cardiac rehabilitation. Conclusion The responses of nonattenders and noncompleters revealed misconceptions related to programme suitability, the intensity of exercise required and the purpose of a cardiac rehabilitation programme. As long as these misconceptions continue to persist in coronary syndrome patients, this will impact upon attendance. The lack of perceived need for cardiac rehabilitation stems from a poor understanding of the programme, especially among nonattenders and noncompleters and subsequently an inability to comprehend possible benefits. Relevance to clinical practice The knowledge of common misconceptions puts clinical nurses in a better position to identify and pro-actively address these erroneous assumptions in their patients in order to improve participation in cardiac rehabilitation. [ABSTRACT FROM AUTHOR]

O objetivo deste estudo retrospectivo foi levantar taxas de desistência e abandono do atendimento em uma clínica-escola de psicologia infantil e identificar fatores de risco sócio-demográficos, clínicos e familiares para ambos os desfechos. Dados de 258 crianças foram obtidos nos prontuários. Desistiram do atendimento logo após a entrevista inicial 16% das famílias. Entre as famílias não desistentes, 49% interromperam o atendimento antes da alta. Foram comparados, quanto aos fatores de risco, os grupos desistente e não desistente. Além disso, no grupo não desistente, os subgrupos abandono (clientes que compareceram ao menos uma vez antes de interromperem o tratamento) e alta clínica (clientes que persistiram até o final do atendimento) também foram comparados. Famílias desistentes apresentaram mais crianças nas séries iniciais, com menos problemas de comportamento. O abandono foi associado a menor recurso cognitivo e menor idade da criança, pai mais jovem e maior exposição da família a estresse psicossocial.El objetivo fue buscar tasas de retirada y abandono del tratamiento en una clínica-escuela de psicología para niños y identificar factores de riesgo demográficos, clínicos y ambientales para ambos los desenlaces. Se utilizaron datos de archivo de 258 niños. No llegaran a iniciar el tratamiento en seguida a la primera entrevista 16% de las familias. Entre las que retornaran, 49% terminaran el tratamiento prematuramente. Se compararan las familias que no regresaran después de la entrevista inicial con las familias que retornaran. Las familias que abandonaran el tratamiento empezado fueran comparadas con las que persistieran hasta el fin. En las familias que no iniciaran en tratamiento los niños tenían menos problemas de conducta y cursaban años iniciales en la escuela. En las familias que abandonaran, los niños eran más jóvenes, tuvieran peor desempeño en test cognitivo, el estatus educativo de los padres era menor y la familia estaba más expuesta a estrés psicosocialThis retrospective study aimed at investigating the rates of treatment nonattendance and dropout at a university-affiliated child guidance clinic and identifying socio demographic, clinical and family risk factors that contribute to them. We obtained archival data of 258 children. Sixteen percent of the families did not return after their intake interview. Among families that returned, forty-nine percent dropped out of treatment. Groups were compared with respect to risk factors for self-termination: nonattenders (clients who did not return after intake) versus attenders (clients who returned); dropouts (clients that attended at least one session before interrupting treatment) versus completers (clients that persisted until treatment conclusion). Children from nonnattender families attended earlier school grades and had less behavior problems. Children in the dropout group had lower scores in intelligence assessment, their fathers were younger and their families were more exposed to psychosocial stress, as compared to completers.

Introduction: Nonattendance is a critical problem that affects health care worldwide. Our aim was to build and validate predictive models of nonattendance in all outpatients appointments, general practitioners, and clinical and surgical specialties., Methods: A cohort study of adult patients, who had scheduled outpatient appointments for General Practitioners, Clinical and Surgical specialties, was conducted between January 2015 and December 2016, at the Italian Hospital of Buenos Aires. We evaluated potential predictors grouped in baseline patient characteristics, characteristics of the appointment scheduling process, patient history, characteristics of the appointment, and comorbidities. Patients were divided between those who attended their appointments, and those who did not. We generated predictive models for nonattendance for all appointments and the three subgroups., Results: Of 2,526,549 appointments included, 703,449 were missed (27.8%). The predictive model for all appointments contains 30 variables, with an area under the ROC (AUROC) curve of 0.71, calibration-in-the-large (CITL) of 0.046, and calibration slope of 1.03 in the validation cohort. For General Practitioners the model has 28 variables (AUROC of 0.72, CITL of 0.053, and calibration slope of 1.01). For clinical subspecialties, the model has 23 variables (AUROC of 0.71, CITL of 0.039, and calibration slope of 1), and for surgical specialties, the model has 22 variables (AUROC of 0.70, CITL of 0.023, and calibration slope of 1.01)., Conclusion: We build robust predictive models of nonattendance with adequate precision and calibration for each of the subgroups., (© 2022 John Wiley & Sons Ltd.)

Background: Nonattendance at scheduled appointments in public hospitals presents a challenge for efficient resource use and may ultimately affect health outcomes due to longer waiting times. Seven percent of all scheduled outpatient appointments in the United Kingdom are estimated to be nonattended. Various reminder systems have been shown to moderately reduce nonattendance, although the effect of issuing fines for nonattendance has not yet been tested in a randomized context. However, such use of financial incentives could impact access to care differently across the different socioeconomic groups. The aim of this study is to assess the effect of fines on hospital outpatient nonattendance.Methods/design: A 1:1 randomized controlled trial of scheduled outpatient appointments was used, with follow-ups until the date of appointment. The setting is an orthopedic clinic at a regional hospital in Denmark. Appointments for users who are scheduled for diagnostics, treatment, surgery, or follow-ups were included from May 2015 to November 2015. Appointments assigned to the intervention arm include an attachment of the appointment letter explaining that a fine will be issued in the case of nonattendance without prior notice. Appointments assigned to the control arm follow usual practice (same system but no letter attachment). The primary outcome is the proportion of nonattendance. Secondary outcomes are proportions of cancellations, sociodemographics, and health-problem characteristics. Furthermore, the intervention costs and production value of nonattended appointments will be measured. An analysis of effect and cost-effectiveness will be conducted based on a 5 % significance level.Discussion: The study is initiated and funded by the Danish Regions, which have the responsibility for the Danish public healthcare sector. The results are expected to inform future decisions about the introduction of fines for nonattendance at public hospitals.Trial Registration: Current Controlled Trials, ISRCTN61925912 . Registered on 6 July 2015. [ABSTRACT FROM AUTHOR]

Aim To explore reasons for non-attendance at type 2 diabetes self-management education. Methods To elicit the main themes explaining non-attendance, 15 semi-structured interviews were conducted with persons referred to, but not attending, self-management education. Systematic text condensation was applied to code and generate themes subsequently organised under individual and organisational factors. Results Individual (illness, lack of perceived benefit) and organisational factors relating to schedule (four whole days, time of day, notification) and content (supermarket visit) were cited as reasons for non-attendance. Conclusions In this study, patients cited both individual and organisational factors as explaining non-attendance at type 2 diabetes self-management education. Further studies should take into account the importance of timing and of tailoring schedules and content to individuals' life situations and resources. As organisational factors are likely to vary across programmes and settings, more case studies are needed to further elucidate the dynamic relationship between individual and organisational factors to explain non-attendance at type 2 diabetes self-management education. [ABSTRACT FROM AUTHOR]

Background: Initial therapy appointments have high nonattendance rates yet the reasons remain poorly understood. Aims: This study aimed to identify positive and negative attitudes towards therapy that predicted initial attendance, informed by a perceptual control theory account of approach-avoidance conflicts in help-seeking. Method: A prospective study was conducted within a low intensity CBT service using first appointment attendance (n = 96) as an outcome. Measures included attitudes towards therapy, depression and anxiety scales, and demographic variables. Results: Endorsement of a negative attitude item representing concern about self-disclosure was independently predictive of nonattendance. Positive attitudes predicted increased attendance, especially endorsement of motives for self-reflection, but only among less depressed individuals. Conclusions: Self-disclosure concerns contribute to therapy avoidance and having goals for self-reflection may represent approach motivation for therapy; however, the latter has less impact among more highly depressed people. [ABSTRACT FROM AUTHOR]

The goal of our study was to understand the characteristics of non-attenders to a first appointment in a mental health center in order to improve the response to the referral. Various characteristics (sex, age, rural or urban provenance, origin of derivation, days on waiting list, destination of derivation, and principal diagnosis) of the patients attended by the service during one year (N = 433) were evaluated and compared with those of the non-attenders during the same period of time (N = 95). First attenders to the mental health service spent less days on the waiting list than non-attenders, and were mostly derived from emergency services. We conclude that first non-attenders unnecessarily enlarge the unit's waiting list, a fact which paradoxically relates to non-attendance of these same patients. The use of several ways to improve the nonattendance rates is discussed. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Nonattendance at outpatient appointment is a major problem particularly in public hospitals that leads to long waiting time and inefficient use of hospital recourses. The aim of this study was to evaluate the effectiveness of sending short message service (SMS) reminders to the mobile phones of patients scheduled for an outpatient appointment on nonattendance rate. Methods: A randomized controlled trial was conducted at three outpatient clinics (General Medicine (GM), Neurology (Neuro), Obstetrics and Gynecology (OB/GYN). Eligible patients were randomly allocated to either receive SMS reminder message of their outpatient appointment (intervention group) or receive no reminder (control group). The electronic database of the hospital was used to collect patient appointment information, mobile phone number, type of clinic and other patient characteristics. The primary outcome measure was nonattendance rate. Chi-square test and multivariate logistic regression were used to compare nonattendance rate between the two groups. Results: A total of 1499 patients were entered in the two arms of the study between April 2011 and June 2011. These were divided as follows (GM=502, Neuro=297, and OB/GYN=700). The nonattendance rate was significantly lower in the reminder groups compared to the non-reminder groups in the GM and Neuro clinics (26.3% vs. 39.8% and 29.3% vs. 43.9%, respectively P ?0.02). There was no significant difference in the nonattendance between the reminder and non-reminder groups in OB/GYN clinic (26.6% vs. 27.9%, P =0.36). Conclusion: SMS text message reminders are effective in reducing the nonattendance rate in outpatient clinics though may not be as effective in all specialities. [Copyright &y& Elsevier]