P2356 - Factors Associated With Absenteeism from Screening Colonoscopy at a Safety Net Endoscopy Center in New York City

Haozhe Sun, MD¹, Syeda H. Salman, MD¹, Haider Ghazanfar, MBBS¹, Sridhar Chilimuri, MBBS², Danial H. Shaikh, MD¹, Nikhitha Mantri, MD², Harish Patel, MD, FACG², Anil Dev, MD^2
1BronxCare Health System, Bronx, NY; ²Bronx Lebanon Hospital Center, Bronx, NY

Introduction: Colorectal cancer is the 3rd leading cause of cancer related death in the United States. Colonoscopy is an effective screening tool shown to decrease the incidence and mortality associated with it. Rates of absenteeism are higher in clinics caring for underserved populations and may contribute to poor health outcomes. We aim to identify factors that lead to missed appointments in our predominantly African American and Latinx community with a high comorbidity burden.

Methods: This retrospective study was conducted as part of the innovation phase of a quality improvement initiative at our safety-net, hospital-based endoscopy center in New York City. All patients scheduled for a screening colonoscopy in 2019 were included. Patients who had failed to appear for their scheduled appointment were compared to patients who completed colonoscopy. Data was abstracted from our EMR. A univariate analysis was done of factors associated with absenteeism from a scheduled screening colonoscopy (Table 1).

Results: The rate of absenteeism in our study was 18.7%. African Americans, presence of higher comorbidity burden, proficiency in English language and a history of substance abuse and psychiatric illness were all associated with higher absenteeism. Appointments that were scheduled in the afternoon, as well as appointments scheduled in the beginning of the week were also factors associated with absenteeism from screening colonoscopy (Table 1). Patients who were married or in a domestic partnership, or had commercial insurance were found to have higher rates of keeping their colonoscopy appointments.

Discussion: Our study was conducted in a safety net health system which provides care to a predominantly underserved ethnic minorities with a high comorbidity burden. Current literature has outlined numerous factors for poor attendance, but there is lack of clarity about important contributing factors.

We have identified several factors in our community which can be targeted in the next phase of our quality initiative to increase screening colonoscopies. Specifically, developing systems to assist with the scheduling of patients with a higher comorbidity index, substance abuse or psychiatric history and exploring models to increase appointments in the beginning of the week. The success of these interventions could provide valuable insights into improving healthcare outcomes in disadvantaged populations.



Disclosures:


Haozhe Sun, MD¹, Syeda H. Salman, MD¹, Haider Ghazanfar, MBBS¹, Sridhar Chilimuri, MBBS², Danial H. Shaikh, MD¹, Nikhitha Mantri, MD², Harish Patel, MD, FACG², Anil Dev, MD². P2356 - Factors Associated With Absenteeism from Screening Colonoscopy at a Safety Net Endoscopy Center in New York City, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.