Administrative and Informatics Determinants of Lost-to-Follow-Up Cases in Outpatient Clinics: The Role of Health Administration, Health Informatics, and Medical Secretarial Practices
DOI:
https://doi.org/10.22399/ijcesen.4690Keywords:
Lost-to-follow-up (LTFU), outpatient clinics, health administration, health informatics, medical secretarial practices, patient retentionAbstract
Lost-to-follow-up (LTFU) in outpatient clinics is a critical failure in care continuity, primarily driven by systemic weaknesses rather than patient behavior alone. Inefficient health administration creates structural barriers through rigid scheduling and punitive no-show policies, while underdeveloped health informatics fails to leverage electronic health records (EHRs) and patient portals for proactive tracking and engagement. Crucially, medical secretarial practices—the human interface of the system—determine whether protocols succeed, as inaccuracies in data management and poor communication directly sever the patient-provider connection. Therefore, reducing LTFU requires an integrated strategy synchronizing patient-centered administrative policies, interoperable health IT systems with predictive analytics, and empowered, well-trained secretarial staff to execute coordinated retention workflows.
References
[1] Mounier-Jack S, Mayhew SH, Mays N. Integrated care: learning between high-income, and low-and middle-income country health systems. Health Policy Plan. 2017;32(suppl_4):iv6–iv12.
[2] Khanh LN, Helenowski I, Zamor K, Scott M, Hoel AW, Ho KJ. Predictors and consequences of loss to follow-up after vascular surgery. Ann Vasc Surg. 2020;68:217–225.
[3] Bernell S, Howard SW. Use Your Words Carefully: What Is a Chronic Disease?
[4] Bailey JE, Wan JY, Tang J, Ghani MA, Cushman WC. Antihypertensive medication adherence, ambulatory visits, and risk of stroke and death. J Gen Intern Med. 2010;25(6):495–503.
[5] Salabati M, Soares RR, Hsu J. Loss to follow-up after anti-VEGF for age-related macular degeneration and diabetic retinopathy. Retin Physician. 2021;2021(18):22–25.
[6] Davis A, Baldwin A, Hingorani M, Dwyer A, Flanagan D. A review of 145 234 ophthalmic patient episodes lost to follow-up. Eye (London) 2017;31(3):422–429.
[7] Skogby S, Bratt E-L, Johansson B, et al. Discontinuation of follow-up care for young people with complex chronic conditions: conceptual definitions and operational components. BMC Health Serv Res. 2021;21(1):1343–1343.
[8] Tien Y-C, Chiu Y-M, Liu M-P. Frequency of lost to follow-up and associated factors for patients with rheumatic diseases. PLoS One. 2016;11(3):e0150816–e0150816.
[9] Boyd ND, Naasan G, Harrison KL, et al. Characteristics of people with dementia lost to follow-up from a dementia care center. Int J Geriatr Psychiatry. 2022;37(1):11.
[10] Sun C-A, Taylor K, Levin S, Renda SM, Han H-R. Factors associated with missed appointments by adults with type 2 diabetes mellitus: a systematic review. BMJ Open Diabetes Res Care. 2021;9(1):e001819.
[11] Kelly BB, Narula J, Fuster V. Recognizing global burden of cardiovascular disease and related chronic diseases. Mt Sinai J Med. 2012;79(6):632–640.
[12] Arksey H, O'Malley L. Scoping studies: towards a methodological framework. Int J Soc Res Methodol. 2005;8(1):19–32.
[13] Lee RRS, Samsudin MuI, Thirumoorthy T, Low LL, Kwan YH. Factors affecting follow-up non-attendance in patients with Type 2 diabetes mellitus and hypertension: a systematic review. Singapore Med J. 2019;60(5):216–223.
[14] Klijs B, Nusselder W, Looman C, Mackenbach J. Contribution of chronic disease to the burden of disability. PLoS One. 2011;6(9):e25325–e25325.
[15] Page MJ, McKenzie JE, Bossuyt PM, et al. The PRISMA 2020 statement: an updated guideline for reporting systematic reviews. BMJ. 2021;372:n71.
[16] Ballard DJ, Strogatz DS, Wagner EH, et al. Hypertension control in a rural southern community: medical care process and dropping out. Am J Prev Med. 1988;4(3):133–139.
[17] Kočiš Krůtilová V, Bahnsen L, De Graeve D. The out-of-pocket burden of chronic diseases: the cases of Belgian, Czech and German older adults. BMC Health Serv Res. 2021;21(1):239–239.
[18] Masuda Y, Kubo A, Kokaze A, et al. Personal features and dropout from diabetic care. Environ Health Prev Med. 2006;11(3):115–119.
[19] Karter AJ, Parker MM, Moffet HH, et al. Missed appointments and poor glycemic control: an opportunity to identify high-risk diabetic patients. Med Care. 2004;42(2):110–115.
[20] Chi BH, Yiannoutsos CT, Westfall AO, et al. Universal Definition of Loss to Follow-Up in HIV Treatment Programs: A Statistical Analysis of 111 Facilities in Africa, Asia, and Latin America. PLoS medicine. 2011;8(10).
[21] World Health Organization. The top 10 causes of death. 2020.
[22] Berghofer G, Schmidl F, Rudas S, Steiner E, Schmitz M. Predictors of treatment discontinuity in outpatient mental health care. Soc Psychiatry Psychiatr Epidemiol. 2002;37(6):276–282.
[23] Schofield D, Shrestha RN, Cunich MM, et al. Economic costs of chronic disease through lost productive life years (PLYs) among Australians aged 45–64 years from 2015 to 2030: Results from a microsimulation model. BMJ Open. 2016;6(9):e011151–e011151.
[24] Minamisawa A, Narumoto J, Yokota I, Fukui K. Evaluation of factors associated with psychiatric patient dropout at a university outpatient clinic in Japan. Patient Prefer Adherence. 2016;10:1903–1911.
[25] Ezquiaga E, García-López A, de Dios C, Agud JL, Albillo D, Vega-Piris L. Seasonality, smoking and history of poor treatment compliance are strong predictors of dropout in a naturalistic 6 year follow-up of bipolar patients. Psychiatr Q. 2014.
[26] Ojukwu EN, Brownlee KJ, Cianelli R. Being lost to follow-up to healthcare appointments: a concept analysis. Nurs Sci Q. 2021;34(4):430–439.
[27] Tyagi S, Koh V, Koh GCH, Low LL, Lee ES. Defining and measuring multimorbidity in primary care in Singapore: results of an online Delphi study. PloS one. 2022;17(12):e0278559–e0278559.
[28] Brewster S, Bartholomew J, Holt RIG, Price H. Non-attendance at diabetes outpatient appointments: a systematic review. Diabet Med. 2020;37(9):1427–1442.
[29] Tricco AC, Lillie E, Zarin W, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467–473.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 International Journal of Computational and Experimental Science and Engineering
This work is licensed under a Creative Commons Attribution 4.0 International License.
