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Discovering patterns in outpatient neurology appointments using state sequence analysis.

Fran Biggin1, Quinta Ashcroft2, Timothy Howcroft2

  • 1Lancaster Medical School, Lancaster University, Bailrigg, Lancaster, LA1 4YG, UK. f.biggin@lancaster.ac.uk.

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|November 5, 2023
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Summary

UK neurology outpatient services face high demand. Analyzing appointment sequences revealed distinct patterns for epilepsy, movement disorders, and headache, offering insights for service improvement.

Keywords:
NeurologyOutpatient appointmentsRoutinely collected dataState sequence analysis

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Area of Science:

  • Neurology
  • Health Services Research
  • Data Science

Background:

  • UK outpatient neurology services are under significant pressure due to demand exceeding capacity.
  • Understanding current appointment patterns is crucial for service improvement.

Purpose of the Study:

  • To explore appointment type patterns in outpatient neurology.
  • To identify opportunities for optimizing neurology outpatient services.

Main Methods:

  • State Sequence Analysis (SSA) applied to routinely collected data from a single neurology clinic.
  • Analysis of appointment sequences for 18 months post-new patient appointment.
  • Clustering of similar appointment sequences to identify common patterns across diagnostic categories.

Main Results:

  • Out of 1315 patients, 887 had a single appointment; 428 had multiple appointments.
  • A 6-monthly appointment cycle was observed in patients with multiple visits.
  • State Sequence Analysis identified 11 distinct appointment sequence clusters.
  • Seizure/epilepsy, movement disorders, and headache diagnoses significantly influenced cluster assignment.

Conclusions:

  • Neurology outpatient appointment sequences exhibit considerable diversity.
  • Specific diagnostic categories share common appointment sequence patterns.
  • These identified patterns can inform the future design and structure of neurology outpatient services.