Improving access to health care in a rural regional hospital in South Africa : why do patients miss their appointments
Date
2017-03
Journal Title
Journal ISSN
Volume Title
Publisher
AOSIS publishing
Abstract
Background: Access to health services is one of the Batho Pele (‘people first’) values and principles of the South African government since 1997. This necessitated some changes around
public service systems, procedures, attitudes and behaviour. The challenges of providing health care to rural geographically spread populations include variations in socio-economic
status, transport opportunities, access to appointment information and patient perceptions of costs and benefits of seeking health care. George hospital, situated in a rural area, serves 5000
outpatient visits monthly, with non-attendance rates of up to 40%.
Objectives: The aim of this research was to gain a greater understanding of the reasons behind
non-attendance of outpatient department clinics to allow locally driven, targeted interventions.
Methods: This was a descriptive study. We attempted to phone all patients who missed
appointments over a 1-month period (n = 574). Only 20% were contactable with one person
declining consent. Twenty-nine percent had no telephone number on hospital systems, 7% had
incorrect numbers, 2% had died and 42% did not respond to three attempts.
Results: The main reasons for non-attendance included unaware of appointment date (16%),
out of area (11%), confusion over date (11%), sick or admitted to hospital (10%), family member
sick or died (7%), appointment should have been cancelled by clerical staff (6%) and transport
(6%). Only 9% chose to miss their appointment. The other 24% had various reasons.
Conclusions: Improved patient awareness of appointments, adjustments in referral systems
and enabling appointment cancellation if indicated would directly improve over two-thirds of
reasons for non-attendance. Understanding the underlying causes will help appointment
planning, reduce wasted costs and have a significant impact on patient care.
Description
CITATION: Frost, L., Jenkins, L.S. & Emmink, B. 2017. Improving access to health care in a rural regional hospital in South Africa: Why do patients miss their appointments. African Journal of Primary Health care & Family Medicine, 9(1): a1255, doi:org/10.4102/phcfm.v9i1.1255. doi:10.4102/phcfm.v9i1.1255
The original publication is available at https://phcfm.org/index.php/phcfm
The original publication is available at https://phcfm.org/index.php/phcfm
Keywords
Primary health care -- South Africa, Family medicine
Citation
Frost, L., Jenkins, L.S. & Emmink, B. 2017. Improving access to health care in a rural regional hospital in South Africa: Why do patients miss their appointments. African Journal of Primary Health care & Family Medicine, 9(1): a1255, doi:org/10.4102/phcfm.v9i1.1255. doi:10.4102/phcfm.v9i1.1255.