UCL Discovery
UCL home » Library Services » Electronic resources » UCL Discovery

Determinants of non-attendance at face-to-face and telemedicine ophthalmic consultations

Wagner, Siegfried K; Raja, Laxmi; Cortina-Borja, Mario; Huemer, Josef; Struyven, Robbert; Keane, Pearse A; Balaskas, Konstantinos; ... Kang, Swan; + view all (2023) Determinants of non-attendance at face-to-face and telemedicine ophthalmic consultations. British Journal of Ophthalmology 10.1136/bjo-2022-322389. (In press). Green open access

[thumbnail of bjo-2022-322389.full.pdf]
Preview
Text
bjo-2022-322389.full.pdf - Published Version

Download (4MB) | Preview

Abstract

BACKGROUND/AIMS: Evaluation of telemedicine care models has highlighted its potential for exacerbating healthcare inequalities. This study seeks to identify and characterise factors associated with non-attendance across face-to-face and telemedicine outpatient appointments. METHODS: A retrospective cohort study at a tertiary-level ophthalmic institution in the UK, between 1 January 2019 and 31 October 2021. Logistic regression modelled non-attendance against sociodemographic, clinical and operational exposure variables for all new patient registrations across five delivery modes: asynchronous, synchronous telephone, synchronous audiovisual and face to face prior to the pandemic and face to face during the pandemic. RESULTS: A total of 85 924 patients (median age 55 years, 54.4% female) were newly registered. Non-attendance differed significantly by delivery mode: (9.0% face to face prepandemic, 10.5% face to face during the pandemic, 11.7% asynchronous and 7.8%, synchronous during pandemic). Male sex, greater levels of deprivation, a previously cancelled appointment and not self-reporting ethnicity were strongly associated with non-attendance across all delivery modes. Individuals identifying as black ethnicity had worse attendance in synchronous audiovisual clinics (adjusted OR 4.24, 95% CI 1.59 to 11.28) but not asynchronous. Those not self-reporting their ethnicity were from more deprived backgrounds, had worse broadband access and had significantly higher non-attendance across all modes (all p<0.001). CONCLUSION: Persistent non-attendance among underserved populations attending telemedicine appointments highlights the challenge digital transformation faces for reducing healthcare inequalities. Implementation of new programmes should be accompanied by investigation into the differential health outcomes of vulnerable populations.

Type: Article
Title: Determinants of non-attendance at face-to-face and telemedicine ophthalmic consultations
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/bjo-2022-322389
Publisher version: https://doi.org/10.1136/bjo-2022-322389
Language: English
Additional information: © 2023 BMJ Publishing Group Ltd. This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license (https://creativecommons.org/licenses/by/4.0/).
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Institute of Ophthalmology
URI: https://discovery.ucl.ac.uk/id/eprint/10170604
Downloads since deposit
13Downloads
Download activity - last month
Download activity - last 12 months
Downloads by country - last 12 months

Archive Staff Only

View Item View Item