Impact of Delayed Time to Advanced Imaging on Missed Appointments Across Different Demographic and Socioeconomic Factors

• Published in: Journal of the American College of Radiology Vol. 15; no. 5; pp. 713 - 720
• Main Authors: Daye, Dania, Carrodeguas, Emmanuel, Glover, McKinley, Guerrier, Claude Emmanuel, Harvey, H. Benjamin, Flores, Efrén J.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.05.2018
• Subjects: Appointments and Schedules; Female; health disparities; Humans; Magnetic Resonance Imaging - statistics & numerical data; Male; Middle Aged; missed appointment; missed care opportunity; MRI; Patient Acceptance of Health Care - statistics & numerical data; Patient engagement; population health management; Retrospective Studies; Risk Factors; socioeconomic; Socioeconomic Factors; Time Factors; CT; Patient engagement; health disparities; missed appointment; population health management; MRI; socioeconomic; missed care opportunity
• ISSN: 1546-1440; 1558-349X
• DOI: 10.1016/j.jacr.2018.01.023

The aim of this study was to investigate the impact of wait days (WDs) on missed outpatient MRI appointments across different demographic and socioeconomic factors. An 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. A 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. Increased 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.