Domiciliary clinics I: effects on non-attendance

Area of Science:

• Geriatric Psychiatry
• Healthcare Delivery Models
• Patient Access to Care

Background:

• High rates of non-attendance in outpatient clinics, particularly in old age psychiatry, lead to inefficient resource allocation.
• Traditional hospital-based assessments may present barriers for elderly patients, contributing to missed appointments.

Purpose of the Study:

• To compare the non-attendance rates between hospital-based clinics and home-based assessments for new referrals to old age psychiatry services.
• To evaluate the effectiveness of home assessments in improving patient attendance and optimizing clinical resources.

Main Methods:

• A prospective study was conducted over four years.
• Two urban old age psychiatry services participated, comparing non-attendance rates for new referrals.
• Data collection focused on comparing hospital-based clinic appointments versus home-based assessments.

Main Results:

• Home assessments demonstrated a substantially lower non-attendance rate of 1.7%.
• Hospital-based clinics had a significantly higher non-attendance rate of 21.2%.
• The difference in non-attendance rates between the two assessment methods was statistically significant.

Conclusions:

• Conducting home-based assessments for new outpatient referrals to old age psychiatry services effectively reduces non-attendance.
• This strategy optimizes the use of medical time and resources within defined urban geographical areas.
• The findings may not be generalizable to rural or larger, more dispersed geographical regions.