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Research ArticleFamily Medicine and the Health Care System

The Association Between Family Medicine Appointment Cancellations and Hospital Utilization in 2019 and 2020

Del G. Carter, Maribeth P. Williams, Benjamin J. Rooks and Peter J. Carek
The Journal of the American Board of Family Medicine April 2023, 36 (2) 339-343; DOI: https://doi.org/10.3122/jabfm.2022.220223R3
Del G. Carter
From the College of Medicine, University of Florida (DGC); Department of Community Health and Family Medicine, University of Florida (MPW, BJR, PJC).
BA
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Maribeth P. Williams
From the College of Medicine, University of Florida (DGC); Department of Community Health and Family Medicine, University of Florida (MPW, BJR, PJC).
MD, MS
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Benjamin J. Rooks
From the College of Medicine, University of Florida (DGC); Department of Community Health and Family Medicine, University of Florida (MPW, BJR, PJC).
MS
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Peter J. Carek
From the College of Medicine, University of Florida (DGC); Department of Community Health and Family Medicine, University of Florida (MPW, BJR, PJC).
MD, MS
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Article Figures & Data

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    Table 1.

    Descriptive Statistics for the ED Patient Population in Spring 2019 and Spring 2020

    20192020p-Value
    n1220658
    Recent Appointment Cancellations289 (23.7%)160 (24.3%)0.805
    Inpatient Admissions267 (21.9%)184 (28.0%)0.004
    Inpatient Readmissions42 (15.8%)30 (16.7%)<0.001
    Average Length of Stay in Days (Median; IQR)3 (5)3 (4)0.157
    Mortality11 (0.9%)10 (1.5%)0.325
    Recent Telemedicine Appointments0 (0%)54 (8.2%)<0.001
    Age (Mean; S.D.)47.2 (52.5)47.2 (16.7)0.989
    Race
    Non-Hispanic White448 (36.8%)256 (39.4%)0.377
    Non-Hispanic Black693 (57.0%)357 (54.9%)0.311
    Hispanic47 (3.9%)22 (3.4%)0.667
    Other32 (2.3%)23 (2.3%)0.354
    Marriage/Life Partner329 (27.1%)174 (26.9%)0.850
    Insured1112 (91.4%)586 (90.0%)0.166
    Psychiatric Diagnosis788 (64.8%)444 (68.2%)0.228
    Substance Abuse Diagnosis545 (44.8%)312 (47.9%)0.276
    Chronic Pain Diagnosis262 (21.5%)128 (19.7%)0.331
    Number of Medications (Median; IQR)16 (20)18 (21)0.016
    Number of Diagnoses (Median; IQR)58 (61)68 (64)<0.001
    • Abbreviations: SD, standard deviation; IQR, Interquartile range; ED, emergency department.

    • View popup
    Table 2.

    Odds/Rate Ratios and 95% Confidence Intervals for the Relationship Between Appointment Cancellations and Hospital Utilization Metrics

    UnadjustedAdjusted*
    Inpatient Admissions1.56 (1.23, 1.98)1.03 (0.78, 1.36)
    Inpatient Readmissions2.09 (1.22, 3.60)2.01 (1.12, 3.61)
    Length of Stay†0.99 (0.80, 1.23)0.90 (0.71, 1.13)
    • ↵* Models adjusted for age, race/ethnicity, marital status, insurance status, the presence of psychiatric, substance abuse, or chronic pain diagnoses, and the number of prescribed medications.

    • ↵† Rate ratios from Poisson regression model.

    • View popup
    Table 3.

    Interaction Coefficients and 95% Confidence Intervals for the Effect of Primary Care Appointment Cancellations on Hospital Utilization Metrics Between 2019 and 2020

    UnadjustedAdjusted*
    Inpatient Admissions0.61 (0.37, 0.99)0.43 (0.24, 0.77)
    Inpatient Readmissions0.58 (0.21, 1.63)0.58 (0.19, 1.74)
    Length of Stay†0.82 (0.53, 1.28)0.75 (0.44, 1.28)
    • ↵* Models adjusted for age, race/ethnicity, marital status, insurance status, the presence of psychiatric, substance abuse, or chronic pain diagnoses, and the number of prescribed medications.

    • ↵† Results from Poisson regression model.

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The Journal of the American Board of Family     Medicine: 36 (2)
The Journal of the American Board of Family Medicine
Vol. 36, Issue 2
March/April 2023
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The Association Between Family Medicine Appointment Cancellations and Hospital Utilization in 2019 and 2020
Del G. Carter, Maribeth P. Williams, Benjamin J. Rooks, Peter J. Carek
The Journal of the American Board of Family Medicine Apr 2023, 36 (2) 339-343; DOI: 10.3122/jabfm.2022.220223R3

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The Association Between Family Medicine Appointment Cancellations and Hospital Utilization in 2019 and 2020
Del G. Carter, Maribeth P. Williams, Benjamin J. Rooks, Peter J. Carek
The Journal of the American Board of Family Medicine Apr 2023, 36 (2) 339-343; DOI: 10.3122/jabfm.2022.220223R3
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