Orthopaedic Trauma Patient Non-adherence to Follow-up Visits at a Level 1 Trauma Center Serving an Urban and Rural Population

  • Kylee Rucinski
    Corresponding Author: Kylee Rucinski, PhD Candidate, Clinical Researcher, Department of Orthopaedic Surgery, Thompson Laboratory for Regenerative Orthopaedics, Missouri Orthopaedic Institute, University of Missouri, 1100 Virginia Ave, Columbia, Missouri 65212
    Department of Orthopaedic Surgery, Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia MO
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  • Emily Leary
    Department of Orthopaedic Surgery, Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia MO
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  • Brett D. Crist
    Department of Orthopaedic Surgery, Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia MO
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  • James L. Cook
    Department of Orthopaedic Surgery, Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia MO
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Published:January 20, 2023DOI:


      • 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.



      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.


      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.


      Data were obtained for 5,816 unique orthopaedic trauma patients who had 21,066 post-treatment follow-up visits scheduled. 1,627 “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.


      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.


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