Velu Preetha, Wilson Carolyn, Kariveda Rohith R, Weber Peter C, Levi Jessica R
Boston University Chobanian and Avedisian School of Medicine.
Otol Neurotol. 2025 Aug 1;46(7):759-765. doi: 10.1097/MAO.0000000000004530. Epub 2025 May 15.
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.
Retrospective chart review.
Tertiary-care, safety-net hospital.
Adult patients seen in an otolaryngology clinic for sensorineural hearing loss between May 1, 2015, and December 31, 2021.
Analysis of patient demographic, medical comorbidity, and appointment factors.
Follow-up appointment attendance rates for otolaryngology and audiology appointments.
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.
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.
感音神经性听力损失具有较高的疾病负担，需要密切随访以管理该疾病的长期后遗症。本研究旨在确定与患者及预约相关的因素，包括人口统计学数据和与成人感音神经性听力损失随访预约就诊相关的医学合并症，以更好地了解护理障碍。
回顾性病历审查。
三级医疗安全网医院。
2015年5月1日至2021年12月31日期间在耳鼻喉科诊所就诊的感音神经性听力损失成年患者。
分析患者人口统计学、医学合并症和预约因素。
耳鼻喉科和听力学预约的随访预约就诊率。
在5632名患者中，54.9%的患者就诊，28.7%的患者取消预约，16.3%的患者未按预约就诊。单因素分析显示，与预约取消和未就诊相关的因素包括性别、种族、语言、教育程度、就业状况、保险、出生国家、住房不安全、高血压、吸烟状况、COVID-19开始之前或之后的预约时间，以及在医院网络内是否有医生。多因素分析显示，与预约未就诊显著相关的因素包括年龄大于60岁、教育水平较高、失业、住房不安全、在医院网络外有初级保健医生，以及居住在距医院5英里半径范围之外。
年龄、教育水平、就业状况、住房不安全和预约距离等患者及预约特征与感音神经性听力损失患者较高的随访预约错过率独立相关。预约的可及性以及远程医疗和提醒系统等干预措施可能是确保公平护理的关键。
