Predictors of No-Show After Facial Trauma: The Effect of a Comprehensive Social Services Program

Background: Trauma patients are at increased risk for loss to follow up, readmission, and re-presentation to emergency departments. Specialists in the Violence Recovery Program (VRP) provide social and mental support, case management, and education to patients to address socioeconomic barriers. We aim to investigate the impact of VRP on no-show rate after facial trauma. Methods: A retrospective review of facial trauma patients consulted to plastic surgery at a Level 1 trauma center was performed. Two cohorts were identified: (1) Low-VRP cohort (May 2018-October 2018) and (2) High-VRP cohort (January 2024-June 2024). Data collected included VRP intervention and demographics including insurance and injury mechanism. Baseline differences between cohorts, and factors affecting no-show rates within cohorts were assessed. Multivariate logistic regression analysis was conducted to determine predictors of no-show. Results: In total, 204 patients were included in the High-VRP cohort and 139 in the Low-VRP cohort. There was a higher rate of no-show in the Low-VRP cohort (n = 42, 30.2%) compared to the High-VRP cohort (n = 32, 15.7%; OR: 2.32, P = .001), and higher VRP intervention in the High-VRP cohort (n = 82, 40.2%) than the Low-VRP cohort (n = 4, 2.9%; OR: 22.73, P < .001). There was not a significant difference in age or gender between cohorts. There was a significant difference found in insurance providers ( P < .001) between cohorts. There was a significant association between no-show rate and gender ( P = .009) within the High-VRP cohort. VRP intervention was significantly associated with clinic attendance in the combined cohort, and remained a significant predictor after regression analysis (OR: 2.50, P = .015). Conclusions: The integration of a comprehensive social services program is associated with decreased no-show rates after facial trauma. This data highlights the impact of social services on patient engagement.