Missed Healthcare Visits During the COVID-19 Pandemic: A Longitudinal Study

Area of Science:

• Health Services Research
• Epidemiology
• Mental Health

Background:

• Missed outpatient visits incur significant costs ($50 billion annually in the U.S.) and lead to healthcare inefficiency and worse patient outcomes.
• The COVID-19 pandemic profoundly altered outpatient healthcare utilization patterns, necessitating an examination of appointment attendance.
• Understanding factors contributing to missed appointments is crucial for improving healthcare access and efficiency.

Purpose of the Study:

• To investigate the frequency of missed outpatient visits during the COVID-19 pandemic.
• To identify patient-level characteristics associated with non-attendance at medical appointments.

Main Methods:

• Utilized data from the longitudinal Chicago COVID-19 Comorbidities (C3) study, analyzing waves 3-8 (May 2020 - May 2022).
• Included 845 English/Spanish-speaking adults with at least one chronic condition.
• Collected data on socio-demographics, health characteristics, health literacy, patient activation, and mental health symptoms via telephone interviews.

Main Results:

• The percentage of participants reporting missed visits due to COVID-19 varied from 3.1% to 22.4% across study waves, showing an overall decline over time.
• No consistent association was found between missed visits and participant socio-demographic or health characteristics.
• Patient-reported anxiety emerged as the sole characteristic significantly associated with missed visits across all study waves.

Conclusions:

• Anxiety consistently correlated with missed outpatient visits throughout the COVID-19 pandemic, independent of socio-demographic or health factors.
• Findings underscore the importance of addressing patients' emotional well-being, particularly anxiety, to mitigate healthcare absenteeism.
• Future public health strategies should consider psychological states to improve appointment adherence during times of crisis.