Improving Access to Specialty Care: Analysis of Factors Affecting Follow-up Patterns in an Outpatient Academic Pulmonary Clinic
Abstract
Prolonged wait times for appointments in pulmonary specialty clinics contribute to worse patient outcomes. We determined the follow-up patterns and factors associated with appointment no-show to identify opportunities to increase appointment availability while improving follow-up. We conducted a retrospective observational cohort study of patients scheduled from 2017-2019 in the outpatient pulmonary fellows’ clinic of an academic tertiary care hospital. A successful visit was an appointment documented as completed. Appointment-level associations with no-show were evaluated using multivariable logistic generalized estimating equations. Among 1,612 patients, 4,689 appointments were scheduled. After excluding 1,247 cancellations and 6 appointments with indeterminate disposition, 3,436 appointments among 1,479 patients were included in the no-show analysis; 1,461 (42.5%) were no-shows. Average intended and actual follow-up intervals were 11.2 weeks and 24.8 weeks, respectively. In the complete-case adjusted analysis (3,427 appointments among 1,470 patients), substance use disorders (adjusted odds ratios [aORs], 1.86-3.43; P≤.011), inpatient referral (aOR, 2.41; P<.001), and pneumonia (aOR, 2.63; P=.046) were associated with greater odds of no-show. Spanish language (aOR, 0.59; P<.001), charity care (aOR, 0.63; P=.002), and external outpatient referral (aOR, 0.49; P<.001) were associated with lower odds. Emergency department referral and driving distance were not independently associated with no-show. Our clinic had short intended follow-up intervals and a high no-show rate. These appointment-level associations may inform continuity-focused scheduling and targeted attendance support. Standardizing follow-up intervals and using prediction-based overbooking should be prospectively evaluated for effects on access, workflow, and patient experience.
Related
- OP–104 Sociodemographic and familial factors affecting the frequency of pediatric outpatient clinic visits
- Improving Awareness of Oman Medical Specialty Board Training Bylaws Among First-Year Pediatric Residents Using a Flipped Classroom Intervention: A Quality Improvement Project
- Bridging the Gap: A Quality Improvement Project Improving Communication Between Community-Based Inpatient and Outpatient Psychiatric Providers
- A Cross-Sectional Study on the Prevalence of Asthma-Chronic Obstructive Pulmonary Disease Overlap in Patients Attending the Pulmonology Outpatient Department at Apollo Institute of Medical Sciences and Research, Chittoor, India
- Real-world antidepressant prescribing patterns in outpatient care: a cross-sectional analysis
BibTeX
@article{drozd2026improving,
title = {{Improving Access to Specialty Care: Analysis of Factors Affecting Follow-up Patterns in an Outpatient Academic Pulmonary Clinic}},
author = {Angelika Drozd MD and Kiera L. Brennan MD and Alexander W. Sudyn MD and Patrick J. Henry MD and Keith Guevarra DO, FCCP and Yonatan Y. Greenstein MD, FCCP},
journal = {Journal of Patient Experience},
year = {2026},
month = oct,
doi = {10.1177/23743735261502057},
url = {https://doi.org/10.1177/23743735261502057},
note = {CC BY},
}
RIS
TY - JOUR
TI - Improving Access to Specialty Care: Analysis of Factors Affecting Follow-up Patterns in an Outpatient Academic Pulmonary Clinic
AU - Angelika Drozd MD
AU - Kiera L. Brennan MD
AU - Alexander W. Sudyn MD
AU - Patrick J. Henry MD
AU - Keith Guevarra DO, FCCP
AU - Yonatan Y. Greenstein MD, FCCP
PY - 2026
DA - 2026/10/24
JO - Journal of Patient Experience
DO - 10.1177/23743735261502057
UR - https://doi.org/10.1177/23743735261502057
AB - Prolonged wait times for appointments in pulmonary specialty clinics contribute to worse patient outcomes. We determined the follow-up patterns and factors associated with appointment no-show to identify opportunities to increase appointment availability while improving follow-up. We conducted a retrospective observational cohort study of patients scheduled from 2017-2019 in the outpatient pulmonary fellows’ clinic of an academic tertiary care hospital. A successful visit was an appointment documented as completed. Appointment-level associations with no-show were evaluated using multivariable logistic generalized estimating equations. Among 1,612 patients, 4,689 appointments were scheduled. After excluding 1,247 cancellations and 6 appointments with indeterminate disposition, 3,436 appointments among 1,479 patients were included in the no-show analysis; 1,461 (42.5%) were no-shows. Average intended and actual follow-up intervals were 11.2 weeks and 24.8 weeks, respectively. In the complete-case adjusted analysis (3,427 appointments among 1,470 patients), substance use disorders (adjusted odds ratios [aORs], 1.86-3.43; P≤.011), inpatient referral (aOR, 2.41; P<.001), and pneumonia (aOR, 2.63; P=.046) were associated with greater odds of no-show. Spanish language (aOR, 0.59; P<.001), charity care (aOR, 0.63; P=.002), and external outpatient referral (aOR, 0.49; P<.001) were associated with lower odds. Emergency department referral and driving distance were not independently associated with no-show. Our clinic had short intended follow-up intervals and a high no-show rate. These appointment-level associations may inform continuity-focused scheduling and targeted attendance support. Standardizing follow-up intervals and using prediction-based overbooking should be prospectively evaluated for effects on access, workflow, and patient experience.
SN - 2374-3743
SN - 2374-3735
ER -