Factors Associated With Follow-Up Appointment Attendance in Adults With Sensorineural Hearing Loss.

OBJECTIVE

Sensorineural hearing loss has a high disease burden and requires close follow-up to manage long-term sequelae of the disease. This study aims to identify patient- and appointment-related factors including demographic data and medical comorbities associated with sensorineural hearing loss follow-up appointment attendance in adults to better understand barriers to care.

STUDY DESIGN

Retrospective chart review.

SETTING

Tertiary-care, safety-net hospital.

PATIENTS

Adult patients seen in an otolaryngology clinic for sensorineural hearing loss between May 1, 2015, and December 31, 2021.

INTERVENTIONS

Analysis of patient demographic, medical comorbidity, and appointment factors.

MAIN OUTCOME MEASURES

Follow-up appointment attendance rates for otolaryngology and audiology appointments.

RESULTS

Of 5,632 patients, 54.9% attended, 28.7% canceled, and 16.3% were no-show at follow-up appointments. On univariate analysis, factors associated with appointment cancellation and no-show included sex, race, language, education, employment status, insurance, country of birth, housing insecurity, hypertension, smoking status, timing of appointments before or after the beginning of COVID-19, and having a physician within hospital network. In multivariate analysis, factors significantly associated with appointment nonattendance included age greater than 60 years old, higher education levels, unemployment, housing insecurity, having a primary care physician outside the hospital network, and residing outside a 5-mile radius of the hospital.

CONCLUSIONS

Patient and appointment characteristics such as age, education level, employment status, housing insecurity, and distance to appointment had an independent association with higher rates of missed follow-up appointments in sensorineural hearing loss. Accessibility of appointments and interventions such as telehealth and reminder systems may be key to ensuring equitable care.