Factors Associated With Follow-Up Appointment Attendance in Adults With Sensorineural Hearing Loss.

Abstract

Objective: Sensorineural hearing loss has a high disease burden and requires close follow-up to manage long-term sequelae of the disease. This study aims to identify patient- and appointment-related factors including demographic data and medical comorbities associated with sensorineural hearing loss follow-up appointment attendance in adults to better understand barriers to care.

Study design: Retrospective chart review.

Setting: Tertiary-care, safety-net hospital.

Patients: Adult patients seen in an otolaryngology clinic for sensorineural hearing loss between May 1, 2015, and December 31, 2021.

Interventions: Analysis of patient demographic, medical comorbidity, and appointment factors.

Main outcome measures: Follow-up appointment attendance rates for otolaryngology and audiology appointments.

Results: Of 5,632 patients, 54.9% attended, 28.7% canceled, and 16.3% were no-show at follow-up appointments. On univariate analysis, factors associated with appointment cancellation and no-show included sex, race, language, education, employment status, insurance, country of birth, housing insecurity, hypertension, smoking status, timing of appointments before or after the beginning of COVID-19, and having a physician within hospital network. In multivariate analysis, factors significantly associated with appointment nonattendance included age greater than 60 years old, higher education levels, unemployment, housing insecurity, having a primary care physician outside the hospital network, and residing outside a 5-mile radius of the hospital.

Conclusions: Patient and appointment characteristics such as age, education level, employment status, housing insecurity, and distance to appointment had an independent association with higher rates of missed follow-up appointments in sensorineural hearing loss. Accessibility of appointments and interventions such as telehealth and reminder systems may be key to ensuring equitable care.