Patient no-shows squander millions

BEN HEATHER AND SHABNAM DASTGHEIB
Last updated 05:00 26/07/2014

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Tens of thousands of patients are failing to show up for their appointments every year, costing the public health system millions.

For some areas and groups, as many as one in three specialist appointments and surgical operations is cancelled due to no-shows, wasting millions in taxpayer dollars and opportunities for other patients to receive specialist care.

Amid an ongoing squeeze on the public health dollar, district health boards are becoming increasingly concerned about the cost of no-shows.

As well as the wasted time and money, patients who don't turn up could be delaying crucial medical care and eventually end up in the emergency departments.

DHBs are trying everything from text alerts to radio ads to remind people to turn up.

Capital & Coast District Health Board chief operating officer Chris Lowry said the region had one of the best rates of attendance, which had improved steadily in the past four years.

But even then more than one in 20 appointments was cancelled because the patient did not turn up.

"It is important patients keep their appointments, as not only does it mean any health issues are picked up early, but it also reduces any delays for other patients waiting to see a specialist," she said.

Taima Fagaloa, the DHB's Pacific health director, said five years ago more than one in five Pacific Islander patients did not attend their surgical or medical appointments but that had since nearly halved.

Conversations with patients with a history of not showing up revealed many feared for their job if they asked for time off.

Others cited difficulty with transport or childcare preventing them from coming. Many just forgot.

The DHB now calls every Pacific Island patient two days before their appointment and in some cases even arranges transport.

In the Hutt Valley about 13,000 medical and surgical appointments are cancelled a year, or about 8 per cent of the total.

Kuini Puketapu, manager of the DHB's maori health advisory unit, said that the board was running a trial called "99 per cent attendance", which had been shown to reduce the rate of non-attendance.

This has included radio advertisements, text messages and gentle reminders from contacts in the community in the lead-up to an appointment.

"When appointments are not attended by patients there is a missed opportunity to provide care, and resources are not used efficiently."

In Hawke's Bay, roughly nine per cent or about 1600 medical and surgical appointments, were not attended last year.

Like elsewhere, the rate was far higher for Maori and Pacific Islanders, who failed to attend about one-sixth of their appointments. About a third of Maori patients did not turn up for dental appointments.

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In a report set to go to the board next week, Hawke's Bay DHB's chief operating officer, Warrick Frater, said there had been "slow progress" on getting Maori, in particular, to attend.

"A high DNA (did not attend) rate suggests there are significant numbers of people whose health may be adversely affected through not receiving timely and appropriate healthcare advice or treatment."

Further north, in Counties Manukau, 4829 patients missed specialist appointments and just under 17,000 missed follow-up appointments in the past year.

Costs varied among the hospitals, but were estimated at $260 for each specialist appointment and $180 for follow-ups in Manukau, translating to a loss of about $4.3 million at that DHB alone.

- The Dominion Post

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