Influence of the Patient/Doctor Relationship on the Non-Attendance Rate of General Practice, and Investigation of Reasons for Hospital Non-Attendance

BACKGROUND: In general practice, though patients often stop visiting ambulatory clinics of their own volition despite the need for ongoing medical treatment, there is little reported research on the reasons for non-attendance in Japan. In this study, we investigated whether the patient/doctor relationship influences non-attendance rates in general practice. In addition, we investigated the reasons why patients stopped visiting the hospital.METHODS: We collected data from 115 patients (58 males, 57 females; age range: 16 to 94 years old, median age: 52 years old) whose initial diagnoses were made in our department from June to July 2000. We classified the patients into five groups based on the level of their complaints concerning the initial consultation ('A' representing the highest degree of complaint, 'E' representing the lowest) and determined the relationship between the strength of complaints and the non-attendance rate. Furthermore, we investigated the reasons for non-attendance concerning 28 patients who stopped visiting the hospital from April 2000 to November 2001.RESULTS: The non-attendance rates were 0%(0/4) for group A, 14.3%(2/14) for group B, 5.6%(5/89) for group C, 33.3%(2/6) for group D, and 50%(1/2) for group E. The rate tended to be higher in groups with fewer complaints. The reasons for non-attendance were the following: remission of symptoms (9 patients), request for another hospital or department (6 patients), relief due to consultation at the university hospital (6 patients), and lack of time to come to the particular hospital (5 patients). In contrast, the most common reason for satisfaction at the time of consultation was 'enough explanation and listening to complaints well' in 7 of 11 patients who were satisfied with the consultation.CONCLUSIONS: The level of patient's complaints at the time of consultation is related to the non-attendance rate. However, sufficient explanation about symptoms and careful listening to complaints are important for establishing a good patient/doctor relationship.