Abstract
The increase in demand for clinical cancer genetics services has impacted the ability to provide services timeously. Given limited resources, this often results in extended appointment waiting times. Over the last 3 years, the Cancer Genetics Service at the National Cancer Centre Singapore has continued to experience a steady increase in demand for its service. Nevertheless, significant no-show rates have been reported. This study sought to determine whether an association exists between appointment waiting times and attendance rates. Data was gathered for all participants meeting inclusion criteria. Attendance rates and appointment waiting times were calculated. The relationship between mean waiting times for those who did and did not attend their scheduled appointments was evaluated using Welch’s t test and linear regression model. The results showed a significant difference in mean appointment waiting times between patients who did and did not attend (32.66 versus 43.50 days respectively; p < 0.0001). Furthermore, patients who waited for longer than 37 days were significantly less likely to attend. No-show rates increased as the waiting time increased, at a rate of 19.60% per 20 days and 21.40% per 30 days. In conclusion, appointment waiting time is a significant predictor for patient attendance. Strategies to ensure patients receive an appointment within the necessary timeframe at the desired setting are important to ensure that individuals at increased cancer risk attend their appointments in order to manage their cancer risks effectively.
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Acknowledgements
We would like to thank colleagues and leadership from the National Cancer Centre Singapore, in particular from the Cancer Genetics Service, for their continued support and contribution towards this study. We would like to thank all doctors from the public and private medical institutions alike for referring their patients to us. Furthermore, we would like to thank all of our patients, without whom our cancer genetics service would not run and this study would not be made possible.
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TS was responsible for the data interpretation and drafting of the manuscript. ZALT was responsible for the statistical analysis of the data and contributed towards the methods section of the manuscript. JM was responsible for the statistical analysis and contributed towards the interpretation of the data. EC and STL gave their critical review of the manuscript for important intellectual content. JN was involved in the conception and design of the study, obtained study funding and contributed towards the critical review of the study to include insightful intellectual content.
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Tarryn Shaw, Julie Metras, Zoe Ang Li Ting, Eliza Courtney, and Shao-Tzu Li declare that they have no conflict of interest.
Joanne Ngeow has received research grants from AstraZeneca for ovarian cancer research.
Human Studies and Informed Consent
The study was approved by the Singhealth Centralized Institutional Review Board (CIRB number 2011/826/B). No informed consent was required from participants as data was anonymously extracted from the electronic booking system. All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1975, as revised in 2000.
Animal Studies
No animal studies were carried out by the authors for this article.
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Shaw, T., Metras, J., Ting, Z.A.L. et al. Impact of Appointment Waiting Time on Attendance Rates at a Clinical Cancer Genetics Service. J Genet Counsel 27, 1473–1481 (2018). https://doi.org/10.1007/s10897-018-0259-z
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DOI: https://doi.org/10.1007/s10897-018-0259-z