Determinants of Nonattendance in a Urology Outpatient Clinic: A 5-Year Retrospective Study in a Tertiary Metropolitan Hospital.

Abstract

Backgrounds: Nonattendance in outpatient healthcare contributes to patient morbidity and healthcare strain. Aboriginal and/or Torres Strait Islander peoples (hereafter, respectively referred to as Indigenous peoples) of Australia experience poorer health outcomes compared to non-Indigenous Australians, with higher rates of nonattendance in outpatient settings. Understanding factors associated with nonattendance is crucial for developing strategies to improve attendance and healthcare inequities. This study aimed to identify factors associated with nonattendance at a urology outpatient clinic and the difference in nonattendance rates between Indigenous and non-Indigenous peoples.

Methods: A secondary data analysis was conducted on urology outpatient clinic attendance at a Brisbane tertiary teaching hospital over 5 years (January 1, 2018 to December 31, 2022). Factors including age, gender, Indigenous status, review type, appointment modality, distance from the clinic, COVID-19 lockdowns, and socioeconomic status were analyzed using chi-square tests and multivariable logistic regression.

Results: Of the 11 683 scheduled appointments, the nonattendance rate was 4.9%. Indigenous patients had a higher nonattendance rate compared to non-Indigenous patients (13.6% vs. 4.6%, OR 2.8, CI 1.91-3.99, p < 0.001). Nonattendance was also associated with age groups less than 54 years of age (p < 0.001) and follow-up appointments (OR 1.73, CI 1.43-2.09, p < 0.001) across the patient population, particularly when the follow-up is scheduled in-person rather than via telehealth (OR 0.4, CI 0.23-0.67, p < 0.001).

Conclusion: Indigenous status, younger age, and follow-up appointment type were significant predictors of nonattendance. Offering follow-up appointments via telehealth may improve attendance. Addressing these disparities is vital for reducing healthcare inequalities and improving health outcomes for Indigenous peoples.