Clinic Study Completion Rate in Orthopedic Surgery.

PURPOSE

The primary aim of this study is to determine the rate of completion of clinic-based study orders. Secondarily, we attempt to determine factors associated with study incompletion.

METHODS

This retrospective study included 591 clinic-based studies that were ordered for 510 patients at the time of clinical evaluation at a single medical center between April 8, 2018 and August 22, 2019. Inclusion criteria were studies ordered in a hand clinic for consecutive adult patients to be completed after the visit. Exclusion criteria included pediatric patients and routine radiographs obtained prior to the visit. Invasive studies were defined as studies with a significant procedural component, such as aspirations, injections and electromyography/nerve conduction (electrodiagnostic) studies (EDS). Blood tests and imaging were considered noninvasive. Patient demographics and study completion rates were collected through chart reviews. Univariate and bivariate analyses were performed, and <.05 was considered significant.

RESULTS

The overall clinic-based study completion rate was 94.2%, with the highest incompletion rates seen in invasive studies (8.3%, n = 34) compared to noninvasive studies (3.3%, n = 10). Within the invasive study category, EDS had the highest rate of incompletion (11.4%) and contributed to the majority of incompletions in the invasive cohort (20/24). The median time to study completion was 7 days (interquartile range [IQR] 2-21). Race, gender, English as primary language, marriage status, insurance type, and distance from facility were similar between completed and noncompleted studies.

CONCLUSION

Study completion rates were similar between all patients regardless of race, gender, and other social economic variables. Invasive studies, particularly EDS, had higher rates of incompletion and can be barriers to patients receiving additional care.

TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic III.