BACKGROUND: Poor patient attendance to scheduled flexible sigmoidoscopy or colonoscopy may contribute to deficient colorectal cancer screening. OBJECTIVE: To examine the association of physician appointment-keeping behavior with attendance to scheduled endoscopic studies of the colon. DESIGN: Retrospective cohort. SETTING: 23 sites performing endoscopic procedures in a health care system. PATIENTS: 11 803 patients scheduled for a first colon study with 3 or more scheduled physician visits from June 1999 through November 2001. MEASUREMENT: 2 outcomes from health system computerized records: 1) attendance at the first scheduled colon study and 2) among nonattendees, attendance at the study rescheduled within 6 months. Physician visit adherence was defined as the proportion of physician visits kept, grouped by quartile. Adjusted associations were examined in conditional logistic regression. RESULTS: Of 11 803 patients, 62% attended the first colon study. Of the 4496 nonattendees, 2739 (61%) rescheduled and, of these, 64% kept that appointment. Compared with the highest quartile of physician visit adherence (>85%), the adjusted odds ratio of attending the first colon study decreased as physician visit adherence decreased: Adjusted odds ratios were 0.94 (95% CI, 0.89 to 1.00) for 76% to 85% adherence, 0.87 (CI, 0.81 to 0.92) for 66% to 75% adherence, and 0.79 (CI, 0.73 to 0.85) for adherence of 65% or less. Among nonattendees who rescheduled, the lowest quartile of physician visit adherence (< or =65%) was the only statistically significant predictor of attending the rescheduled study (adjusted odds ratio, 0.87 [CI, 0.78 to 0.98]). LIMITATIONS: The adherence measure applies only to patients with at least 3 scheduled visits. Persons having a colon study outside of the system could have been misclassified. CONCLUSION: Physician appointment-keeping behavior predicted attendance to colorectal endoscopic studies in this cohort and may help identify persons who need interventions to promote adherence.
BACKGROUND: Poor patient attendance to scheduled flexible sigmoidoscopy or colonoscopy may contribute to deficient colorectal cancer screening. OBJECTIVE: To examine the association of physician appointment-keeping behavior with attendance to scheduled endoscopic studies of the colon. DESIGN: Retrospective cohort. SETTING: 23 sites performing endoscopic procedures in a health care system. PATIENTS: 11 803 patients scheduled for a first colon study with 3 or more scheduled physician visits from June 1999 through November 2001. MEASUREMENT: 2 outcomes from health system computerized records: 1) attendance at the first scheduled colon study and 2) among nonattendees, attendance at the study rescheduled within 6 months. Physician visit adherence was defined as the proportion of physician visits kept, grouped by quartile. Adjusted associations were examined in conditional logistic regression. RESULTS: Of 11 803 patients, 62% attended the first colon study. Of the 4496 nonattendees, 2739 (61%) rescheduled and, of these, 64% kept that appointment. Compared with the highest quartile of physician visit adherence (>85%), the adjusted odds ratio of attending the first colon study decreased as physician visit adherence decreased: Adjusted odds ratios were 0.94 (95% CI, 0.89 to 1.00) for 76% to 85% adherence, 0.87 (CI, 0.81 to 0.92) for 66% to 75% adherence, and 0.79 (CI, 0.73 to 0.85) for adherence of 65% or less. Among nonattendees who rescheduled, the lowest quartile of physician visit adherence (< or =65%) was the only statistically significant predictor of attending the rescheduled study (adjusted odds ratio, 0.87 [CI, 0.78 to 0.98]). LIMITATIONS: The adherence measure applies only to patients with at least 3 scheduled visits. Persons having a colon study outside of the system could have been misclassified. CONCLUSION: Physician appointment-keeping behavior predicted attendance to colorectal endoscopic studies in this cohort and may help identify persons who need interventions to promote adherence.
Authors: Barbara J Turner; Mark Weiner; Sheila D Berry; Karen Lillie; Kevin Fosnocht; Christopher S Hollenbeak Journal: J Gen Intern Med Date: 2007-11-21 Impact factor: 5.128
Authors: Michael Greenspan; Navdeep Chehl; Krista Shawron; Lisa Barnes; Hong Li; Elizabeth Avery; Shannon Sims; John Losurdo; Sohrab Mobarhan; Joshua Melson Journal: Dig Dis Sci Date: 2015-04-23 Impact factor: 3.199
Authors: Jennifer Elston Lafata; Gregory S Cooper; George Divine; Susan A Flocke; Nancy Oja-Tebbe; Kurt C Stange; Tracy Wunderlich Journal: Am J Prev Med Date: 2011-11 Impact factor: 5.043
Authors: Thomas D Denberg; Trisha V Melhado; John M Coombes; Brenda L Beaty; Kenneth Berman; Tim E Byers; Alfred C Marcus; John F Steiner; Dennis J Ahnen Journal: J Gen Intern Med Date: 2005-11 Impact factor: 5.128
Authors: Lindsey A Jones; Carol Estwing Ferrans; Blase N Polite; Katherine C Brewer; Ajay V Maker; Heather A Pauls; Garth H Rauscher Journal: Ann Epidemiol Date: 2017-10-13 Impact factor: 3.797
Authors: Daniel M Blumenthal; Gaurav Singal; Shikha S Mangla; Eric A Macklin; Daniel C Chung Journal: J Gen Intern Med Date: 2015-01-14 Impact factor: 5.128