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• W1925930069 abstract "Background:  Service evaluation of general dietetic outpatient clinics is necessary to identify areas of poor attendance because these occurrences may adversely affect clinic waiting lists, efficiency levels, the health outcome of patients and the cost to the National Health Service. Although some studies have looked at increasing attendance of new appointments (Burns et al., 2008), few have explored whether there is a relationship between ‘did not attend’ (DNA) rates and any trends in the type of appointment patients have been referred for. This service evaluation aimed to distinguish subgroups of patients referred to the general clinics in terms of percent attendance and to re-evaluate strategies to improve attendance.Methods:  Data were collected on patients attending a general adult dietetic outpatient clinic over a period of 6 months from January to June 2010. The clinic offered an initial dietetic assessment appointment of 30 min in duration and, if required, follow-up appointment(s) of 15 min in duration. Patients were grouped, retrospectively, by the initial presenting referral request, for example weight loss, diet controlled diabetes (including impaired glucose tolerance and impaired fasting glucose), polycystic ovary syndrome (PCOS), women's health (including IVF), liver diet advice, chronic obstructive pulmonary disease, irritable bowel syndrome and general weight gain. The gender, type of appointment and outcome of appointments, including DNA rates, were collected. The total population was then allocated to one of two groups based on their reason for referral into awomen's health (excluding women referred for liver diet advice or gastro) and a weight management group (excluding patients referred for general weight gain (including for IVF), liver diet advice or gastro).Results:  The results show that 63% attended the whole clinic, 11% called to cancel and rearranged the appointment and 26% DNA. The highest DNA rate was in the weight management group (27%) and this group also had the lowest percentage of patients cancelling their appointments. Table 1 shows the % DNA and cancellation rates as well as female to male and new to follow-up appointment ratios.Table 1.   Characteristics of patients attending a general dietetic outpatient clinic ClinicnFemale : MaleNew : Follow-up% DNA rateF : M % DNA% cancelledn, number; F, female; M, male. *Unable to define new:follow-up data because the general women's health group contains data from multiple sources (e.g. PCOS, IVF, weight management).Total clinic44067 : 3345 : 5526%51 : 4911Weight management28767 : 3345 : 5527%53 : 477General women's Health234100% female–*19%1917Discussion:  The DNA rate for general women's health of 19% was lower than the total clinic level of 26% but their cancellation rate was the highest at 17% (versus 11% for the total clinic). Cancellation is an area that requires further investigation because it is unclear whether more cancellations were made more than 24 h before the clinic and whether patients had been selected from an emergency list. The study by Dockerty (1992) showed that long waiting lists followed by a new appointment resulted in a higher likelihood for DNA or cancellation. Encouraging patients to cancel appointments in advance may help reduce waiting lists and cost to outpatient services.Conclusions:  In this cohort, 26% of patients DNA and 11% cancelled their appointments, with the women's groups showing the highest cancellation rate (17%) and lowest DNA (19%). Further work needs to be conducted to identify reasons for DNA and clinic cancellations. No difference in DNA rates was found between sexes in the total clinic; however, additional research is needed to assess other factors affecting attendance such as age, language, underlying clinical condition, number of co-morbidities, mobility status, employment status, understanding of reason for referral, expectation of what a dietitian can offer, education of patients, social barriers, physician's age and knowledge, transport, ill-health and financial constraints.References:  Burns, F.M., Mercer, C.H., Evans, A.R., Gerry, C.J., Mole, R. and Hart, G.J. (2008) Increased attendances of people of eastern European origin at sexual health services in London. Sex Transm. Infect. 85,75–78.Dockerty, J.D. (1992) Outpatient clinic nonarrivals and cancellations. N. Z. Med. 105,147–149." @default.
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• W1925930069 date "2011-07-04" @default.
• W1925930069 modified "2023-09-30" @default.
• W1925930069 title "Service evaluation of attendance at general dietetic outpatient clinics" @default.
• W1925930069 doi "https://doi.org/10.1111/j.1365-277x.2011.01177_28.x" @default.
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