Patients who miss GP appointments die earlier: study

Even an occasional no-show is bad for your health

Patients who occasionally miss a GP appointment — even just one a year – have a higher rate of mortality compared with those who always show up, an analysis of more than 800,000 patients suggests.

empty waiting room

In a UK study of more than 11 million appointments, patients who missed one or two appointments a year had a mortality rate twice as high as those who never missed them.

Among those who missed more than two appointments a year in the three-year study period, the rate was threefold.

The effect was greater among patients with long-term mental health conditions than patients with only physical health complaints.

Writing in BMC Medicine, the authors said missing an appointment could reflect an exacerbation of a mental health condition, which, when poorly managed, contributed to mortality.

“Patients with long-term mental health conditions who missed more than two appointments per year had a greater than eightfold increase in risk of all-cause mortality compared with those who missed no appointments.

“These patients died prematurely, commonly from non-natural external factors such as suicide.”

Alcohol or substance use disorders were probably responsible for a significant number of missed appointments and patient deaths, they argued.

Patients with either of these conditions were more likely to miss multiple appointments a year than patients with depression, anxiety, dementia or schizophrenia.

The authors, led by researchers from the University of Glasgow, said the explanation might be different for patients with physical health complaints.

In these cases, missing out on the healthcare that was to be offered at the appointment could be the cause of the increased mortality rate, they suggested, rather than the missed appointment being a red flag for something else.

The study showed that even patients who only missed a low number of appointments - one, two or three over the three-year period - had a mortality rate 55% higher than those who never missed an appointment.

The results were adjusted for factors such as distance from the practice and the delay between the booking and the appointment date.

More information: BMC Medicine 2019.

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