Hip fractures are a major cause of burden in terms of mortality, disability, and costs. In Ireland, 3000 hip fracture occur annually and is expected to increase over the coming years1. Estimated cost of hip fractures is &z.euro;14 300/admission2. Outpatient non-attendance is a source of inefficiency, wasting time, resources and lengthens waiting lists. Non attendees have a significant negative impact on productivity, their own care and resources. In 2008, an estimated 25 000 out-patient appointments were broken in our institution, at an estimated cost of &z.euro;3 800 0003.
Aim: To identify the reasons for non attendance at an osteoporosis clinic following hip fracture.
Methodology: Hip fracture patients admitted to study site from June 2008 to June 2010 assessed by an orthogeriatric team and offered an appointment in a Bone Health Clinic.
Results: 394 hip fracture patients were admitted to study site. 57 (14%) got no appointment as 26 (7%) did not want one, 13 (3%) were too frail, 8 (2%) were non-residents in country/county and 10 (2%) had metastatic disease. 197 (50%) attended for a clinic appointment while 140 (36%) did not. Mean age of non attendees 77.5 years. Reasons for non attendance are tabulated below.
|Longterm care (cognitive impairment±reduced mobility)||21 (15%)|
|Alcohol excess||5 (4%)|
|Cognitive impairment||25 (18%)|
|Reduced mobility||24 (17%)|
Conclusion: Non-attendance at outpatient appointment is considered an indicator of poorer access to health care services and may lead to worse health outcomes, increasing costs and waiting times. In order for health service providers to be able to allocate adequate resources for the management of hip fractures, accurate figures for fracture rates and outcomes should be measured. Given the current economic climate, methods need to be employed to reduce non-attendance.
17 May 2014 - 20 May 2014