Non-attendance in adult dermatological patients.

377 Letters to the Editor Sir, Non-attendance (failure to attend clinic appointments) is a common problem in dermatology clinics. Non-attendance proportions range from 15% to 25% and lead to inefficient use of space and personnel and increased costs (1–7). To improve the management of dermatological clinics, factors that determine non-attendance should be identified and addressed. In the past, only a few studies were performed on non-attendance in general dermatology clinics. The factors that determine non-attendance in adult dermatology clinics include the payer type, inadequate communication between the hospital and patients, patients forgetting their appointment date or illness, and problems related to appointments (8–11). In paediatric dermatolo-gical patients, non-attendance was associated with male gender and referrals from emergency department as opposed to referrals from private physicians (12). In this study we investigated factors that determine non-attendance in adults visiting an ambulatory dermatology clinic. The study was conducted in the southern district of Clalit Health Services. Clalit Health Services is the largest organization of managed care in Israel. In the southern district of Israel, Clalit Health Services serves a population of 470,000 enrollees. The dermatology service in this district includes 17 active dermatologists , working in 23 clinics, accounting for approximately 110,000 patient–physician encounters annually. The central ambulatory clinic resides in the district town Beer-Sheva. Visits to district central ambulatory clinic were obtained from a computer-generated listing of scheduled appointments from January 1 to December 31, 2003. The list contained the patient's age, gender, visit date and time, waiting time for an appointment and the treating dermatologist for all new appointments in the clinic. In this clinic, patients were not required to pre-authorize the appointment and did not receive a reminder of the scheduled appointment. Statistical analysis Results of continuous variables are shown as means. Results of categorical variables are described as frequencies. Chi-square tests were used to analyse statistically significant differences of categorical variables. Logistic regression was used for multivariate analyses. p-values ≤ 0.05 were considered statistically significant. reSUlTS A total of 7580 visits were included in the study during a 12-month period. There were 4509 female (59.5%) and 3071 male (40.5%) patients. The mean age was 45.9 years (range 18–100 years). The overall proportion of non-attendance at the dermatology clinic was 26.1%. Non-attendance was 27.2% in female and 24.5% in male patients (p = 0.009). Non-attendance was 30.1% in patients below 50 years, 21.4% in patients in the age range …