Poster Presentation 2025 Joint Meeting of the COSA ASM and IPOS Congress

Reducing appointment non-attendance in cancer care using the Equity Process Framework: preliminary findings from the RE-FRAME pilot study (126643)

Brighid Scanlon 1 2 3 , David Wyld 2 3 , Natasha Roberts 3 4 , Jo Durham 1 , Michael Smith 1 2 , Alison Alexander 2 , Morgan Farley 1 , Kimberly Alexander 1 2
  1. Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
  2. Royal Brisbane and Women's Hospital, Herston, QLD, Australia
  3. Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
  4. Surgical, Treatment and Rehabilitation Service (STARS), Metro North Health, Brisbane, Queensland , Australia

Objectives/Purpose:

Appointment non-attendance has significant and detrimental impacts on cancer outcomes, contributing to the widening of disparities between populations. Literature demonstrates that patients who fail to attend scheduled appointments often experience negative outcomes such as disease progression, higher symptom burden, or failure to complete planned treatment. This study pilot tested the Equity Process Framework as a structured, strengths-based guide to address the issue of non-attendance and operationalise health equity in cancer outpatient services.

 

Sample and setting:

Data were collected to examine appointment non-attendance between June 2023- June 2025, in the cancer care outpatient services of a large, tertiary level facility in metropolitan Queensland. All individuals associated with appointment non-attendance were screened for inclusion in the sample. A total of 13936 episodes were screened.

 

Procedures:

A retrospective cohort study was conducted using routinely collected data in the electronic medical records. Dependent variables included number of missed appointments and appointment type. Independent variables included a range of socio-demographic, clinical and service utilisation variables. Descriptive statistics were generated to summarise the characteristics of populations with appointment non-attendance in the aggregate sample. Bivariate analyses were then conducted to assess associations between sociodemographic variables and non-attendance rates. Finally, hierarchical cluster analysis was performed using SPSS to identify distinct patterns within the data.

 

Results:

A range of socio-demographic, clinical and service utilisation measures were associated with appointment non-attendance. These included socio-economic status, Aboriginal and Torres Strait Islander status and travel distance to hospital. Preliminary findings suggest the utility of Equity Process Framework in identifying priority populations and establishing inequities, using measurable and reproducible indicators.

 

Conclusion and clinical implications:

The Equity Process Framework may provide health services with a solutions-focused tool to inform cancer equity research, policies, and service improvements. Ongoing pilot research is being undertaken to evaluate the effectiveness of this framework in clinical settings.