Causes of appointment attendance, nonattendance, and cancellation in outpatient consultations at a university hospital

Abstract

Summary Background Nonattendance to scheduled appointments in outpatient clinics is a frequent problem in ambulatory medicine with an impact on health systems and patients' health. The characterization of nonattendance is fundamental for the design of appropriate strategies for its management. Aims To identify causes of nonattendance of scheduled ambulatory medical appointments by adult patients. Methods Case and two controls study nested in a prospective cohort. A telephone‐administered questionnaire was applied within the first 72 hours to identify the causes of attendance, nonattendance, or cancellation in patients who had a scheduled appointment to which they had been present, absent, or cancelled. Results A total of 150 absences (cases), 176 attendances, and 147 cancellations (controls) in a prospective cohort of 160 146 scheduled appointments (2012/2013) were included. According to self‐reports in telephone interviews, the most frequent causes of nonattendance were forgetting 44% (66), unexpected competing events 15.3% (23), illness or unwellness 12% (18), work‐related inconvenience 5.3% (8), transport‐related difficulties 4.7% (4), and cause that motivated appointment scheduling already resolved 4.7% (4). Discussion The main cause of nonattendance is forgetting the scheduled appointment, but there is a proportion of different causes that do not respond to reminders but could respond to different strategies.

Coping with no-show behaviour in appointment services: a multistage perspective

“…Regarding no-show reasons, prior studies have identified cost, transportation, coordination and forgotten appointments as principal reasons for patients' no-shows (Briatore et al, 2020). Unlike these works, our study has linked influencing factors of no-show behaviour to different appointment service stages and established some essential no-show reasons that were overlooked in prior studies.…”

“…The common factors in prior studies were: lead time, demographics, weather, transportation, distance, visit type, previous no-show experience and payment forms (Al Rowaili et al, 2016;Briatore et al, 2020;Norris et al, 2014;Perez et al, 2014). In these studies, scholars used a multivariate linear regression method to examine the relationship between no-shows and various factors and found the most impactful factors in influencing consumers' no-show behaviour (Li et al, 2019;Nasir et al, 2020).…”

“…The common factors in prior studies were: lead time, demographics, weather, transportation, distance, visit type, previous no-show experience and payment forms (Al Rowaili et al. , 2016; Briatore et al. , 2020; Norris et al.…”

Estratégias para o enfrentamento do absenteísmo de pacientes em consultas e exames agendados pelos sistemas de saúde: Uma revisão integrativa

“…É importante ter conhecimento das características e distribuição das faltas, visto que uma possível redução do absenteísmo de usuários pode implicar na passagem de faltas para cancelamentos (Briatore et al, 2019). Assim, as estratégias definidas devem considerar, além do sistema de saúde em si, os diversos atores envolvidos na atenção à saúde.…”

Patient absenteeism in outpatient consultations: an integrative literature review

“…In the Metropolitan Health Region of the state of Espírito Santo, absenteeism in scheduled medical appointments was 38.6%, leading to losses to the individual and the service administration (10) . In a public university hospital in Argentina, the absenteeism rate reaches 21.3% (11) . The World Health Organization mentions, in the World Health Report "Health Systems Financing, The Path to Universal Coverage", the difficulty of countries, regardless of their wealth, to meet the population's universal health needs, as well as the waste of health resources around 20 to 40%, hindering the improvement of the quality of services provided (12) .…”