Impact of Delayed Time to Advanced Imaging on Missed Appointments Across Different Demographic and Socioeconomic Factors |
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| Affiliation: | 1. Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts;2. Harvard Medical School, Boston, Massachusetts;3. Institute for Technology Assessment, Massachusetts General Hospital, Boston, Massachusetts;1. Department of Radiology, University of Washington, Seattle, Washington;2. Department of Medicine, University of Washington, Seattle, Washington;3. UW Medicine Center for Scholarship in Patient Care Quality and Safety, University of Washington, Seattle, Washington;4. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania;5. Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;6. Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania;7. Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, Pennsylvania;1. Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, Texas;3. Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, Michigan;1. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia;2. Department of Radiology, University of Kentucky, Lexington, Kentucky;1. Harvard Medical School, Boston, Massachusetts;2. Department of Radiology, Massachusetts General Hospital, Boston, Massachusetts;3. Massachusetts General Hospital Institute for Technology Assessment, Boston, Massachusetts;1. Colorado State University, Fort Collins, Colorado;2. Radiology Associates, Templeton, California;1. Department of Radiology, Virginia Mason Medical Center, Seattle, Washington;2. Department of Radiology, University of Washington, Seattle, Washington;3. Department of Medicine, University of Washington, Seattle, Washington;4. UW Medicine Value and Systems Science Lab, Seattle, Washington;5. Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, Pennsylvania;6. Department of Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania;7. Perelman School of Medicine, the University of Pennsylvania, Philadelphia, Pennsylvania;8. Institute for Biomedical Informatics, University of Pennsylvania, Philadelphia, Pennsylvania |
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| Abstract: | PurposeThe aim of this study was to investigate the impact of wait days (WDs) on missed outpatient MRI appointments across different demographic and socioeconomic factors.MethodsAn institutional review board–approved retrospective study was conducted among adult patients scheduled for outpatient MRI during a 12-month period. Scheduling data and demographic information were obtained. Imaging missed appointments were defined as missed scheduled imaging encounters. WDs were defined as the number of days from study order to appointment. Multivariate logistic regression was applied to assess the contribution of race and socioeconomic factors to missed appointments. Linear regression was performed to assess the relationship between missed appointment rates and WDs stratified by race, income, and patient insurance groups with analysis of covariance statistics.ResultsA total of 42,727 patients met the inclusion criteria. Mean WDs were 7.95 days. Multivariate regression showed increased odds ratio for missed appointments for patients with increased WDs (7-21 days: odds ratio [OR], 1.39; >21 days: OR, 1.77), African American patients (OR, 1.71), Hispanic patients (OR, 1.30), patients with noncommercial insurance (OR, 2.00-2.55), and those with imaging performed at the main hospital campus (OR, 1.51). Missed appointment rate linearly increased with WDs, with analysis of covariance revealing underrepresented minorities and Medicaid insurance as significant effect modifiers.ConclusionsIncreased WDs for advanced imaging significantly increases the likelihood of missed appointments. This effect is most pronounced among underrepresented minorities and patients with lower socioeconomic status. Efforts to reduce WDs may improve equity in access to and utilization of advanced diagnostic imaging for all patients. |
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| Keywords: | Patient engagement health disparities population health management MRI CT missed appointment missed care opportunity socioeconomic |
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