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Original Research

J Phys Ther. 2013; 7(1): 12-22

Non-Attendance for Out-Patient Physiotherapy: Evaluation, Prediction and Physiotherapists’ Perceptions- a Cross-Sectional Study

Chidozie Emmanuel Mbada,a*, Oluwatosin Ajayi,a, Oyinade Bokime Agbeja,a, Kikelomo Aboyowa Mbada,b, Taofeek Oluwole Awotidebe,a, Saturday N. Oghumu,a..

Introduction and Objective: Non-attendance constitutes significant challenge at outpatient physiotherapy clinics. This study sought to estimate the rate of non-attendance for out-patient physiotherapy, to identify patients at risk of missing an appointment using a prediction model and to assess the perceptions of physiotherapists on factors influencing patient’s non-attendance.
Materials and Methods: A 3-year retrospective audit of a Nigerian teaching hospital out-patient physiotherapy clinic was carried out. 1069 case charts were reviewed but only 930 were found valid for analysis. Data were gleaned on socio-demographic variables (age, sex, month of appointment and location of residence), referrer and diagnosis. The cross-sectional part of the study involved 60 consenting physiotherapists from selected hospitals from south-west, Nigeria. An adapted questionnaire was used to elicit perceived factors for patients’ non-attendance. Descriptive statistics of percentages were used to summarize data. Inferential statistics of logistic regression was used to obtain the predictive model for non-attendance at 0.05 alpha level.
Results: The total non-attendance rate was 57.3%. Non-attendance rate was higher among female than male patients (58.6 vs. 41.4%), patients with neurological conditions (72.5%), referrals from general practitioner (68%), patients not residing in the same location as the clinic (60.2%) and an appointment in the month of December (75.9%). The logistic regression model’s diagnostic accuracy to predict non-attendance could account for only 11.4% variability using variables such as age, sex, distance to clinic, referral source, month of referral and patient’s condition. Patient’s treatment progress (88.3%), cost of care (86.7%) and patient’s travel distance to clinic (93.3%) respectively were the most agreed patients’, organizational and extrinsic factors affecting out-patient physiotherapy attendance. Cost of care (43.3%), patient’s travel distance to clinic (36.7%) and patient’s treatment progress (23.3%) were the top three implicated factors for non-attendance.
Conclusion: Non-attendance for out-patient physiotherapy appointment was high among Nigerian patients. Socio-demographic factors, referrer and type of illness could collectively predict non-attendance but not without significant errors. Cost of care, patients’ travel distance and patient’s treatment progress were the most important perceived factors affecting attendance for out-patient physiotherapy among Nigerian patients.

Key words: Evaluation, patient non-attendance, prediction, physiotherapy out-patient adherence

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