Demographic Profile, Cost Implications And Deprivation Analysis Of Did Not Attend (DNA) Patients In An Established Diabetic Retinal Screening Service

1. Roland Ling¹
2. Salman Waqar¹
3. Rabia Salman²
4. Gill Bullen³

¹West of England Eye Unit, Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K
²London School of Hygiene and Tropical Medicine, London, U.K
³North & East Devon Retinal Screening Service, Royal Devon and Exeter NHS Foundation Trust, Exeter, U.K

PURPOSE: To identify the demographic and socio-economic profiles of DNA patients in order to improve future compliance and to assess the financial impact of DNA's on an established diabetic retinal screening service.

METHODS: 1 year retrospective analysis of DNA patients between April'09 and March'10.

RESULTS:The North and East Devon screening programme has been running since 1994. Patients were identified using our electronic screening software (Orion DRSS, Orion Imaging Ltd). A total of 19215 patients were invited to screening with 2182 (11.35%) DNA's (1800 once and 382 twice). 1279 (59%) were males and 903 (41%) were females. Average age of first time DNA's was 62 and repeat DNA's was 57 years. 5.5% (n=121) were newly diagnosed diabetics and 0.83% (n= 18) were new to the area. Seasonal variations were noted with increased DNA rates in September, October and March. Cost per DNA patient was calculated with the total cost to the service coming to £78,259. No significant difference was found in DNA rates between catchment areas based on average full time (median) weekly workplace earnings.

CONCLUSIONS:A significant number of patients did not attend our well–established screening service despite regular reminders. A considerable proportion of these were newly diagnosed diabetics. The financial implications of lost appointments can justify investment in more efficient electronic systems and improve compliance. Further understanding of the reasons for non-attendance is needed and a prospective study is currently underway to ascertain these.