WVU researchers seek to understand patients’ geographic barriers in new study

Researchers at the West Virginia University School of Medicine are exploring the factors in what causes patients to “no show” to for follow-up sleep studies to diagnose sleep disordered breathing that was detected during their hospital stay.

Sunil Sharma, M.D., division chief and professor within the Department of Medicine, and his team looked into a variety of variables including patient- and community-level factors affecting “no-show” rates for sleep study testing with an innovative utilization of medical geography techniques.

“We’ve established through previous studies that the chance for hospital readmission for patients with sleep disordered breathing goes down with early detection and treatment,” Dr. Sharma explained. “The more we can understand the roadblocks that patients encounter getting to follow up appointments, the more resources we can utilize more effectively to help them get the care they need.”

The findings were released in the Journal of Clinical Sleep Medicine.

The team analyzed data from a four-year period that included more than 1,300 hospitalized patients who were referred to a sleep clinic. Approximately 80% of the patients didn’t follow up on the referral.

Using geospatial coding to analyze zip codes in West Virginia, they were able to pinpoint the likelihood patients would keep appointments. Patients in more densely populated areas, north central West Virginia for example, were more likely to go to the sleep study than patients in more rural, southern West Virginia counties where travel is time consuming and difficult due to terrain.

However, an equally important factor which negatively affected no-show rates was health literacy. After adjusting to multiple variables distance and health literacy were the strongest influencers on no-show rate. This highlighted the importance of educating the patients on the disease and how it affects their co-morbid conditions and overall well-being before patients get discharged.

Sharma emphasized that in a climate of limited resources, prioritizing data-driven interventions is essential. The study revealed that directing efforts and resources toward patient education may yield the greatest impact in reducing no-show rates. Sharma added leveraging technology to address healthcare challenges is crucial.

Other WVU researchers on the team included Robert Stansbury, M.D., and Eddie Rojas, M.D. from the Department of Medicine; Priyanka Srinivasan; and Kassandra Olgers from the Physician Assistant Studies program; Wes Kimble, BS; Brian Hendricks, Ph.D.; Timothy Dotson, Ph.D.; Brian A. Witrick, Ph.D. from the West Virginia Clinical and Translational Science Institute and Scott Knollinger from Respiratory Care Department at J.W. Ruby Memorial Hospital.

For more information about the Department of Medicine, visit medicine.wvu.edu/medicine/.