278 Outpatient "Did Not Attend" Episodes: A Cohort Study Investigating Influencing Factors

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Abstract Aim Outpatient "Did Not Attend" (DNA) episodes represent a significant financial burden to healthcare systems, with an estimated cost of £1 billion for the NHS. Understanding factors that contribute to DNA episodes is crucial for optimizing healthcare resource utilization. We examined a cohort of outpatient clinics within the general surgery department at South Tees Hospitals NHS Foundation Trust to identify factors associated with DNA episodes. Method A prospectively collected database of all outpatient clinics was interrogated from 01/01/2021, to 31/03/2023. Information on patient age, gender, appointment type (new vs. follow-up, face-to-face vs. remote), index of multiple deprivation (IMD) decile, and driving distance was recorded for each clinic attendance. Results Of 19,769 clinic appointments, 1,509 (8%) resulted in DNAs. Disproportionate number of patients with DNAs resided in the lowest IMD decile (19%), compared to other deciles (range: 6.4%-10%). Driving distance did not differ between attended (median: 16 km, IQR: 6-30 km) and DNA groups (median: 15 km, IQR: 5-30 km). DNA rates did not vary between remote (8%) and face-to-face (7%) clinics. Multivariable binary logistic regression found older age, IMD, and hospital site as predictors of outpatient DNA. Individuals who were younger and from the lowest IMD decile were more likely to DNA. Conclusions Outpatient DNA is multifactorial. Travel distance/duration and remote consultations did not influence attendance in our cohort. Working-age patients and those residing in lower IMD deciles were more likely to DNA. Solely relying on remote consultations may not be sufficient to effectively address DNA episodes.

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