Non-English Speakers Attend Gastroenterology Clinic Appointments at Higher Rates Than English Speakers in a Vulnerable Patient Population
- 1 August 2009
- journal article
- alimentary tract
- Published by Ovid Technologies (Wolters Kluwer Health) in Journal of Clinical Gastroenterology
- Vol. 43 (7), 652-660
- https://doi.org/10.1097/mcg.0b013e3181855077
Abstract
Goals We sought to identify factors associated with gastroenterology clinic attendance in an urban safety net healthcare system. Background Missed clinic appointments reduce the efficiency and availability of healthcare, but subspecialty clinic attendance among patients with established healthcare access has not been studied. Study We performed an observational study using secondary data from administrative sources to study patients referred to, and scheduled for an appointment in, the adult gastroenterology clinic serving the safety net healthcare system of San Francisco, CA. Our dependent variable was whether subjects attended or missed a scheduled appointment. Analysis included multivariable logistic regression and classification tree analysis. A total of 1833 patients were referred and scheduled for an appointment between May 2005 and August 2006. Prisoners were excluded. All patients had a primary care provider. Results Six hundred eighty-three patients (37.3%) missed their appointment; 1150 patients (62.7%) attended. Language was highly associated with attendance in the logistic regression; non-English speakers were less likely than English speakers to miss an appointment [adjusted odds ratio 0.42 (0.28, 0.63) for Spanish, 0.56 (0.38, 0.82) for Asian language, P<0.001]. Other factors were also associated with attendance, but classification tree analysis identified language to be the most highly associated variable. Conclusions In an urban safety net healthcare population, among patients with established healthcare access and a scheduled gastroenterology clinic appointment, not speaking English was most strongly associated with higher attendance rates. Patient-related factors associated with not speaking English likely influence subspecialty clinic attendance rates, and these factors may differ from those affecting general healthcare access.Keywords
This publication has 39 references indexed in Scilit:
- Substance abuse treatment and receipt of liver specialty care among persons coinfected with HIV/HCV who have alcohol problemsJournal of Substance Abuse Treatment, 2006
- Delayed Access to Health Care and MortalityHealth Services Research, 2006
- Parental English Proficiency and Children’s Health Services AccessAmerican Journal of Public Health, 2006
- Linguistic disparities in health care access and health status among older adultsJournal of General Internal Medicine, 2006
- Racial Variations in Treatment and Outcomes of Black and White Patients With High-Risk Non–ST-Elevation Acute Coronary SyndromesCirculation, 2005
- Improving Identification of Hispanic Males in MedicareMedical Care, 2004
- Ethnicity, socio-economic position and gender—do they affect reported health—care seeking behaviour?Social Science & Medicine, 2003
- Why do patients not keep their appointments? Prospective study in a gastroenterology outpatient clinicJournal of the Royal Society of Medicine, 2002
- Racial Differences in the Treatment of Early-Stage Lung CancerThe New England Journal of Medicine, 1999
- Predictors of outpatient medical appointment attendance among persons with HIVAIDS Care, 1999