Missed physiotherapy appointment and its influence on cost, efficiency and patients’ outcomes

Fatoye, Francis ORCID: https://orcid.org/0000-0002-3502-3953, Esther, Afolabi Olubukola, Gebrye, Tadesse ORCID: https://orcid.org/0000-0001-7976-2013, Oyewole, Olufemi O, Fatoye, Clara, Fasuyi, Francis and Mbada, Chidozie E ORCID: https://orcid.org/0000-0003-3666-7432 (2024) Missed physiotherapy appointment and its influence on cost, efficiency and patients’ outcomes. Annali di igiene: medicina preventiva e di comunita, 36 (1). pp. 3-14. ISSN 1120-9135

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Abstract

Background: Missed appointments (MAs) is a significant challenge to efficient running of physiotherapy departments and it has cost implications. In this study, wait time and the pattern and impact of MAs on cost, efficiency, and patient outcome was assessed among Nigerian patients receiving physiotherapy. Method: In this retrospective study a total of 3243 physiotherapy appointments booked between 2009 and 2019 at an Outpatient Physiotherapy Clinic in Nigeria. were conducted. Data were gleaned on socio-demographic and patient outcomes related to MAs. The total revenue loss due to MAs was calculated as a product of the total of MAs and per treatment cost. Results: MAs constituted 1701 (52.5%) of all appointments and the average wait time for the first appointment was 9.6 ± 23.2 days. The proportion of MAs was higher among females (50.2%), patients who were not residents within the same location as the clinic (45.3%), patients with orthopaedic conditions (56.2%) and patients referred from an orthopaedic surgeon (32.8%). Females, those who live far within the city, and those with neurological/medical conditions were 1.68, 1.24, and 1.52 times more likely to have MAs compared with males (OR = 1.68, CI = 1.44 – 1.96, p = < 0.001), and those who live outside the city (OR = 1.24, CI = 1.05 – 1.46, P = 0.01), and have orthopaedic conditions (OR = 1.52, CI = 1.20 – 1.93, p = <0.001), respectively. Using per treatment schedule cost of N1000 (an equivalent of $2.31), a 52.5% MAs rate resulted in lower efficiency of 76.6% with an efficiency ratio of 0.23. Further, a 52.5% MAs rate could potentially impact patient recovery by 3402 days if MAs slow a patient recovery process by 2 days. Conclusions: MAs for physiotherapy treatment pose a significant challenge in terms of costs, efficiency, and patient outcomes. Thus, an innovative reminder system may help reduce patients’ non-attendance to physiotherapy and its consequences.