Back to the program

Screening for violence and access to health care: study of experiences of violence and attendance at general medical appointments

Eloïse ROY and Sohela MOUSSAOUI

Missed appointments affect 6 to 10% of general practice patients in France, representing approximately 27 million absences annually. The main causes include forgetfulness, personal or professional constraints, and logistical or financial obstacles. These absences more frequently affect vulnerable populations such as young people, the elderly, those in precarious situations, or those with psychiatric disorders. Current solutions are primarily punitive and could exacerbate the marginalization of these patients.The following study aims to evaluate a non-punitive approach to reintegration into care.A health center in the Paris region implemented a system to remind patients who had missed their appointment with a general practitioner and offer them a new appointment within a reasonable time frame. These consultations systematically included time dedicated to screening for violence, using digital tools and educational resources for practitioners. The study targeted patients over the age of 18 who had previously consulted at the health center and missed an appointment without notice between February and September 2024. The objective of the study was to assess the proportion of violence newly identified during appointments offered to patients who had missed a general medicine appointment.A total of 287 patients missed an appointment without notice, and of these, 151 were contacted by phone to reschedule a consultation. Sixty-one patients (40.4%) accepted a second appointment, and 31 (50.8%) actually attended. During systematic screening, 61.1% of those screened (N=11), reported violence, including 63.6% (N=7) that were previously unknown to healthcare professionals.Despite the low sample size due to a hard-to-reach population, the program illustrates the value of a proactive approach to turning missed appointments into opportunities for intervention.These results highlight the importance of improving access to care for vulnerable populations and strengthening systematic screening for violence.