Reduction of missed appointments at an urban primary care clinic: a randomised controlled study
Open Access
- 25 October 2010
- journal article
- research article
- Published by Springer Science and Business Media LLC in BMC Family Practice
- Vol. 11 (1), 79
- https://doi.org/10.1186/1471-2296-11-79
Abstract
Missed appointments are known to interfere with appropriate care and to misspend medical and administrative resources. The aim of this study was to test the effectiveness of a sequential intervention reminding patients of their upcoming appointment and to identify the profile of patients missing their appointments. We conducted a randomised controlled study in an urban primary care clinic at the Geneva University Hospitals serving a majority of vulnerable patients. All patients booked in a primary care or HIV clinic at the Geneva University Hospitals were sent a reminder 48 hrs prior to their appointment according to the following sequential intervention: 1. Phone call (fixed or mobile) reminder; 2. If no phone response: a Short Message Service (SMS) reminder; 3. If no available mobile phone number: a postal reminder. The rate of missed appointment, the cost of the intervention, and the profile of patients missing their appointment were recorded. 2123 patients were included: 1052 in the intervention group, 1071 in the control group. Only 61.7% patients had a mobile phone recorded at the clinic. The sequential intervention significantly reduced the rate of missed appointments: 11.4% (n = 122) in the control group and 7.8% (n = 82) in the intervention group (p < 0.005), and allowed to reallocate 28% of cancelled appointments. It also proved to be cost effective in providing a total net benefit of 1846. - EUR/3 months. A satisfaction survey conducted with 241 patients showed that 93% of them were not bothered by the reminders and 78% considered them to be useful. By multivariate analysis, the following characteristics were significant predictors of missed appointments: younger age (OR per additional decade 0.82; CI 0.71-0.94), male gender (OR 1.72; CI 1.18-2.50), follow-up appointment >1year (OR 2.2; CI: 1.15-4.2), substance abuse (2.09, CI 1.21-3.61), and being an asylum seeker (OR 2.73: CI 1.22-6.09). A practical reminder system can significantly increase patient attendance at medical outpatient clinics. An intervention focused on specific patient characteristics could further increase the effectiveness of appointment reminders.Keywords
This publication has 33 references indexed in Scilit:
- Missed Visits and Mortality among Patients Establishing Initial Outpatient HIV TreatmentClinical Infectious Diseases, 2009
- Effectiveness of mobile-phone short message service (SMS) reminders for ophthalmology outpatient appointments: Observational studyBMC Ophthalmology, 2008
- Comparison of an SMS text messaging and phone reminder to improve attendance at a health promotion center: A randomized controlled trialJournal of Zhejiang University-SCIENCE B, 2008
- Patient mobile telephone ‘text’ reminder: a novel way to reduce non-attendance at the ENT out-patient clinicThe Journal of Laryngology & Otology, 2007
- Why do patients not keep their appointments? Prospective study in a gastroenterology outpatient clinicJournal of the Royal Society of Medicine, 2002
- Determinants of attrition from cessation treatment in smokers with a history of major depressive disorder.Psychology of Addictive Behaviors, 2000
- Determinants of attrition from cessation treatment in smokers with a history of major depressive disorder.Psychology of Addictive Behaviors, 2000
- Predictors of outpatient medical appointment attendance among persons with HIVAIDS Care, 1999
- Missed appointments and Medicaid managed careArchives of Family Medicine, 1996
- Failure to Keep Appointments at a Community Health Centre: Analysis of causesScandinavian Journal of Primary Health Care, 1990