This study, led by Dr Andrea Williamson in Glasgow, uses the records of over 800,000 people in Scotland to help us understand the phenomenon of repeated missed appointments in General Practice. GP records were linked to other administrative datasets containing data on mortality, hospital admissions etc.
Two important publications have already had a significant influence on policy and practice. Ellis et al (Demographic and practice factors predicting repeated non-attendance in primary care: a national retrospective cohort analysis. Lancet Public Health 2017;2(12):e551-e59. doi: 10.1016/S2468-2667(17)30217-7) showed that repeated missed appointments are significantly more common among people living in deprived areas and among both young adults and older people, but also that practice-related factors were important.
McQueenie et al (Morbidity, mortality and missed appointments in healthcare: a national retrospective data linkage study. BMC medicine 2019;17(1):2-2. doi: 10.1186/s12916-018-1234-0) showed that people who miss more than two appointments per year over three years have a very annual high mortality rate (about 5%) independently of the number of long-term conditions they have.
The association of missing many appointments with mortality is particularly marked among people without physical long-term conditions: these patients generally die at a very young age, and from non-natural causes. Work is ongoing to investigate the association of missed appointments with ADHD, Adverse Childhood Experiences, hospital service use and unmet health needs.
McQueenie R, Ellis DA, Fleming M, Wilson P, Williamson AE. Educational associations of school attendance, exclusions and attainment with missed GP appointments for patients under 35 years old: administrative data linkage study. BMC Medicine 2021, 19:219. Doi: 10.1186/s12916-021-02100-7
Williamson AE, McQueenie R, Ellis DA, McConnachie A, Wilson P. ‘Missingness’ in health care: associations between hospital utilization and missed appointments in general practice. A retrospective cohort study. PLoS One PONE-D-20-37099R2
Ellis DA, McQueenie R, Williamson AE, Wilson P. Missed Appointments in Health Care Systems: A National Retrospective Data Linkage Project. SAGE Research Methods Cases: Medicine and Health 2020. DOI: https://dx.doi.org/10.4135/9781529723014
Williamson A, McQueenie R, Ellis D, McConnachie A, Wilson P. General practice recording of Adverse Childhood Experiences. BJGP Open 2020, 1-9 DOI: 10.3399/bjgpopen20X101011
Wilson P, McQueenie R, Ellis D, Williamson, A. Missed GP appointments linked to higher risk of death (letter). BMJ 2019, 364, l485. https://www.bmj.com/content/364/bmj.l485.full
McQueenie R, Ellis DA, McConnachie A, Wilson P, Williamson AE. Morbidity, mortality and missed appointments in healthcare: a national retrospective data linkage study. BMC Medicine 2019, 17:2 https://doi.org/10.1186/s12916-018-1234-0 (Winner of RCGP Health Services Research Paper of the Year 2020)