Highlights
- •Key demographic and psychosocial factors were associated with patient adherence to scheduled follow-up appointments after treatment.
- •Various factors contribute to no-show appointments particularly in certain demographics.
- •Patients at higher risk for nonadherence should be identified to allow healthcare teams to provide better care and improve adherence for follow up appointments.
Abstract
Objective
To assess key demographic and psychosocial variables that may be associated with non-adherence
to clinic visits following orthopaedic trauma injuries to patients in an urban and
rural population.
Methods
This retrospective review included all operative and non-operative patients presenting
to a Level I academic trauma center serving an urban and rural population in the Midwest
following an orthopaedic injury. The study tracked patient attendance to scheduled
orthopaedic trauma follow-up clinic visits after a scheduled visit in the clinic following
a trauma-related injury.
Results
Data were obtained for 5816 unique orthopaedic trauma patients who had 21,066 post-treatment
follow-up visits scheduled. 1627 “no-show” appointments were recorded. Factors associated
with no-shows included male sex, age between 26 and 35 years, self-reported race other
than white, employment listed as disabled, household income below $25,000, education
less than a high school level, uninsured, Medicaid insured, and relationship status
reported as single.
Conclusions
In the present study, key demographic and psychosocial factors were significantly
associated with patient adherence to scheduled follow-up appointments after treatment
for orthopaedic trauma. Identifying patients at higher risk for nonadherence will
allow healthcare teams to educate patients, providers, and staff, link patients to
resources to enhance adherence, and work with their institutions to develop and implement
protocols for improving adherence to follow-up appointments.
Keywords
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References
- Evaluation of orthopedic trauma surgery follow-up and impact of a routine callback program.Orthopedics. 2017; 40https://doi.org/10.3928/01477447-20161229-01
- Who is lost to followup? A study of patients with distal radius fractures.Clin Orthop Relat Res. 2010; 468: 599-604https://doi.org/10.1007/s11999-009-0968-6
- What factors influence follow-up in orthopedic trauma surgery?.Arch Orthop Trauma Surg. 2015; 135: 321-327https://doi.org/10.1007/s00402-015-2151-8
- Resource use data by patient report or hospital records: do they agree?.BMC Health Serv Res. 2002; 2: 2https://doi.org/10.1186/1472-6963-2-2
- Follow-up compliance and outcomes of knee ligamentous reconstruction or repair patients enrolled in an electronic versus a traditional follow-up protocol.Orthopedics. 2018; 41: e718-e723https://doi.org/10.3928/01477447-20180828-02
- A compliance and satisfaction with home exercise: a comparison of computer-assisted video instruction and routine rehabilitation practice.J Allied Health. 2005; 34: 76-82
- Patient comprehension and compliance survey to assess postoperative pain regimens in the orthopaedic trauma population.J Orthop Trauma. 2017; 31: e190-e194https://doi.org/10.1097/BOT.0000000000000822
- Patient motivation and adherence to postsurgery rehabilitation exercise recommendations: the influence of physiotherapists’ autonomy-supportive behaviors.Arch Phys Med Rehabil. 2009; 90: 1977-1982https://doi.org/10.1016/j.apmr.2009.05.024
- A randomized clinical trial comparing reported and measured wear rates in clubfoot bracing using a novel pressure sensor.J Pediatr Orthop. 2015; 35: 185-191https://doi.org/10.1097/BPO.0000000000000205
- Health literacy in orthopaedic trauma patients.J Orthop Trauma. 2017; 31: e90-e95https://doi.org/10.1097/BOT.0000000000000764
- Age and socioeconomic status affect access to telemedicine at an urban level 1 trauma center.OTA Int. 2021; 4: e155https://doi.org/10.1097/OI9.0000000000000155
- Healthcare disparities among orthopedic trauma patients in the USA: socio-demographic factors influence the management of calcaneus fractures.J Orthop Surg Res. 2019; 14: 359https://doi.org/10.1186/s13018-019-1402-8
- Predicting completion of follow-up in prospective orthopaedic trauma research.OTA Int. 2019; 2: e047https://doi.org/10.1097/OI9.0000000000000047
- Factors associated with trauma clinic follow-up compliance after discharge: experience at an urban Level I trauma center.J Trauma Acute Care Surg. 2014; 76: 185-190https://doi.org/10.1097/TA.0b013e3182aafcd5
- Does insurance status matter at a public, level I trauma center?.J Trauma. 2010; 68: 211-216https://doi.org/10.1097/TA.0b013e3181a0e659
- The socioeconomic impact of orthopaedic trauma: a systematic review and meta-analysis.PLoS ONE. 2020; 15 (Farouk O, ed.)e0227907https://doi.org/10.1371/journal.pone.0227907
- The role of sociodemographics in the occurrence of orthopaedic trauma.Injury. 2019; 50: 1288-1292https://doi.org/10.1016/j.injury.2019.05.018
- Determinants of return to work following non life threatening acute orthopaedic trauma: a prospective cohort study.J Rehabil Med. 2010; 42: 162-169https://doi.org/10.2340/16501977-0495
- Insurance status and hospital discharge disposition after trauma: inequities in access to postacute care.J Trauma. 2011; 71: 1011-1015https://doi.org/10.1097/TA.0b013e3182092c27
- Revisiting the behavioral model and access to medical care: does it matter?.J Health Soc Behav. 1995; 36: 1https://doi.org/10.2307/2137284
Quickfacts: Columbia, Missouri.; 2019. https://www.census.gov/quickfacts/fact/table/columbiacitymissouri/PST045219
- Health in rural Missouri.Department of Health and Senior Services, 2015
Cornelius M, Wang T, Jamal A, Loretan C, Neff L. Tobacco product use among adults — United States, 2019.; 2020:1736-1742.
- Effect of health literacy on adherence to osteoporosis treatment among patients with distal radius fracture.Arch Osteoporos. 2017; 12: 42https://doi.org/10.1007/s11657-017-0337-0
- The impact of health literacy in the care of surgical patients: a qualitative systematic review.BMC Surgery. 2015; 15: 86https://doi.org/10.1186/s12893-015-0073-6
- Poverty and pain: low-SES people are believed to be insensitive to pain.J Exp Soc Psychol. 2021; 95104116https://doi.org/10.1016/j.jesp.2021.104116
- The relationship between socioeconomic status and trauma outcomes.J Public Health. 2018; 40: e431-e439https://doi.org/10.1093/pubmed/fdy033
- Health-related quality of life 24 months after sustaining a minor musculoskeletal injury in a road traffic crash: A prospective cohort study.Traffic Injury Prevent. 2017; 18: 251-256https://doi.org/10.1080/15389588.2016.1244335
- Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites.Proc Natl Acad Sci USA. 2016; 113: 4296-4301https://doi.org/10.1073/pnas.1516047113
- The lost to trauma patient follow-up: a system or patient problem.J Trauma Acute Care Surg. 2012; 73: 1507-1511https://doi.org/10.1097/TA.0b013e31826fc928
- Effect of cultural factors on outcome of Ponseti treatment of clubfeet in rural America.J Bone Joint Surg Am. 2009; 91: 530-540https://doi.org/10.2106/JBJS.H.00580
- The challenge of patient adherence.Ther Clin Risk Manag. 2005; 1: 189-199
- Non-adherence to prescribed home rehabilitation exercises for musculoskeletal injuries: the role of the patient-practitioner relationship.J Rehabil Med. 2014; 46: 153-158https://doi.org/10.2340/16501977-1241
- Why don't patients do their exercises? Understanding non-compliance with physiotherapy in patients with osteoarthritis of the knee.J Epidemiol Community Health. 2001; 55: 132-138https://doi.org/10.1136/jech.55.2.132
- Physician-patient communication: a lost art?.J Am Acad Orthop Surg. 2002; 10: 95-105https://doi.org/10.5435/00124635-200203000-00005
- What factors affect patient access and engagement with clubfoot treatment in low- and middle-income countries? Meta-synthesis of existing qualitative studies using a social ecological model.Trop Med Int Health. 2016; 21: 570-589https://doi.org/10.1111/tmi.12684
- Reducing readmission rates through a discharge follow-up service.Future Healthc J. 2019; 6: 114-117https://doi.org/10.7861/futurehosp.6-2-114
- Telemedicine use in orthopaedic surgery varies by race, ethnicity, first language, and insurance status.Clin Orthop Relat Res. 2021; (Publish Ahead of Print)https://doi.org/10.1097/CORR.0000000000001775
- Local access to care programs increase trauma patient follow-up compliance.Am J Surg. 2014; 208: 476-479https://doi.org/10.1016/j.amjsurg.2013.11.008
- Patient coping and expectations predict recovery after major orthopaedic trauma.Br J Anaesth. 2019; 122: 51-59https://doi.org/10.1016/j.bja.2018.06.021
- The importance of written and verbal information on pain treatment for patients undergoing surgical interventions.Pain Manag Nurs. 2015; 16: 634-641https://doi.org/10.1016/j.pmn.2014.12.003
- Disparities in trauma care and outcomes in the United States: a systematic review and meta-analysis.J Trauma Acute Care Surg. 2013; 74: 1195-1205https://doi.org/10.1097/TA.0b013e31828c331d
- Effects of compliance with procedure-specific postoperative rehabilitation protocols on initial outcomes after osteochondral and meniscal allograft transplantation in the knee.Orthop J Sports Med. 2019; 72325967119884291https://doi.org/10.1177/2325967119884291
- Communication skills training for surgical residents: learning to relate to the needs of older adults.J Surg Educ. 2018; 75: 1180-1187https://doi.org/10.1016/j.jsurg.2018.02.005
- Initial program evaluation of the Ponseti method in Nigeria.Iowa Orthop J. 2012; 32: 141-149
- Use and usability of custom-made orthopedic shoes.J Rehabil Res Dev. 2010; 47: 73-81https://doi.org/10.1682/jrrd.2009.08.0142
- Assessing the longitudinal impact of physician-patient relationship on functional health.Ann Fam Med. 2020; 18: 422-429https://doi.org/10.1370/afm.2554
- The impact of a phone assistance nursing program on adherence to home exercises and final outcomes in patients who underwent shoulder instability surgery: a randomized controlled study.Orthop Nurs. 2018; 37: 372-378https://doi.org/10.1097/NOR.0000000000000501
Article info
Publication history
Published online: January 20, 2023
Accepted:
January 19,
2023
Editor: R BuckleyPublication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd. All rights reserved.
