WCPT Africa Region Conference System, 9th WCPT Africa Region Congress

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An Estimation of Missed Appointments for Out-patient Physiotherapy and its Impact on Efficiency and Cost
Chidozie Emmanuel Mbada, Oluwatosin Ajayi, Justice Nonvignon, Olubusola Esther Johnson, Taofeek Oluwola Awotidebe, Olumide Olasunkanmi Dada

Last modified: 2012-02-06

Abstract


Background and Objective: Missed appointments (MA) represent a momentous challenge for out-patient physiotherapy clinics administrators as it leads to potential increase in recovery time, reduced number of scheduled slots for other patients, and reduced clinic revenue. Conversely, this has not been experientially put into perspective in Nigeria. The objective of this study was to estimate rates of MA for out-patient physiotherapy and its impact on efficiency and cost.

Materials and Methods: A retrospective study was conducted on physiotherapy out-patient clinic attendances at the Obafemi Awolowo University Teaching Hospitals Complex, Ile-Ife, Nigeria from 2006 to 2008. 1069 case charts were reviewed but only 930 were with complete information and analysed. Data were gleaned on age, sex, number of missed appointment, location of residence, source of referral and diagnosis. MA was defined as a follow-up appointment a patient does not show up for or comes to make a re-book. Efficiency was calculated as the ratio of the actual number of patients served versus the number of patients that could have been served; while total revenue loss to MA was calculated as a product of total number of MA and per treatment cost.  

Results: MA comprised of 79.2% of all appointments. Only 50% on the average of scheduled appointments were kept by the patients. The rates of missing 1st, 2nd and 3rd follow-up appointments were 8.2, 11.1 and 11.9% respectively.  More female than male patients (78.0% and 80.3%) were liable to miss an appointment. Higher rate of MA (91.3%) was observed among patients with neurological conditions. MA lowered efficiency by as much as 57.3%. If MA slows the patient’s recovery process by 2 days, then 79.2% MA could potentially impact patient recovery time by 1474 days. If per treatment schedule cost $10 in revenue, a 79.2% MA rate will result in $7370 in lost revenue and 737 lost opportunities to treat patients.

Conclusion: There is a high rate of MA for out-patient physiotherapy among Nigerian patients.  This huge number of MA signifies important losses in terms of cost and efficiency for patient care.

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