Examining the Association of Social Determinants of Health with Missed Clinic Visits in Patients with Heart Failure in the Veterans Health Administration

  • Charlie M. WrayEmail author
  • Marzieh Vali
  • Amy Byers
  • Salomeh Keyhani
Concise Research Report


Missed clinic visits, or no-shows, are a significant resource drain on the Veterans Health Administration (VA).1 The VA reports that 15–18% of scheduled primary care appointments are not completed, costing an estimated half a billion dollars per year.2 While some social determinants of health (SDOH) are shown to influence clinic no-show rates in other populations, no prior work has explored their effect among Veterans. Focusing on a cohort that require frequent clinic visits, our goal was to assess the association of three SDOH with missed clinic visits among Veterans hospitalized for congestive heart failure (CHF).


From a national sample, we first identified all Veterans 65 and older who were hospitalized for hearth failure, then randomly selected 1500 hospitalized with a primary diagnosis of CHF in 2012. Based on previous work,3three SDOH (lives alone, social support, and housing situation) were extracted and verified through chart abstraction by two reviewers....


Funding Information

This work was supported by NHLBI R01 RO1 HL116522-01A1.

Compliance with Ethical Standards

Conflict of Interest

The authors report no conflicts of interest in the submission of this manuscript


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Copyright information

© Society of General Internal Medicine (This is a U.S. government work and not under copyright protection in the U.S.; foreign copyright protection may apply) 2019

Authors and Affiliations

  1. 1.Department of Medicine University of CaliforniaSan FranciscoUSA
  2. 2.Division of Hospital Medicine, San Francisco Veterans Affairs Medical CenterUniversity of California San FranciscoSan FranciscoUSA
  3. 3.Northern California Institute for Research and EducationSan Francisco Veterans Affairs Medical CenterSan FranciscoUSA
  4. 4.Department of PsychiatryUniversity of CaliforniaSan FranciscoUSA
  5. 5.Mental Health ServicesSan Francisco Veterans Affairs Medical CenterSan FranciscoUSA
  6. 6.Division of General Internal MedicineSan Francisco Veterans Affairs Medical CenterSan FranciscoUSA

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