Dermatology missed appointments: an analysis of outpatient non-attendance in a general hospital's population

Guedes, Rita; Leite, Inês; Baptista, Armando

doi:10.1111/j.1365-4632.2012.05710.x

Cited by 10 publications

(14 citation statements)

References 12 publications

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“…In this study, the non-attendance rate was 9.5%, which is consistent with previous studies from different medical settings showing non-attendance rates ranging from 2 to 30% [ 5 , 7 , 8 , 13 – 16 ]. Comparison between these studies should be done with caution due to very varying settings and study populations.…”

Section: Discussionsupporting

confidence: 92%

“…On the other hand, patients arrive early more often than late, and patient earliness may also be undesirable, since it creates overcrowding in the waiting area and potentially reduces the patient logistics, which in turn can be a challenge to both the patient and the front-desk staff [ 1 ]. Previous research on outpatient clinic scheduling and patient flow has mainly focused on late arrivals [ 2 – 4 ] and no-shows/ non-attendance [ 5 – 10 ]. Age and gender have previously been suggested as potential factors for non-attendance [ 7 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Association between age and outpatient clinic arrival time: myth or reality?

Faiz

Kristoffersen

2018

BMC Health Serv Res

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BackgroundNon-attendance and late arrivals diminish patient flow in outpatient clinics. On the other hand, patient earliness may also be undesirable. Physicians often experience that older patients are more punctual than younger patients, and often they come excessively early. The aim of this study was to determine whether an association between age and outpatient clinic arrival time could be established or not, i.e. to find out if it is a myth or a reality.MethodsProspective descriptive study performed at a neurological outpatient clinic. Data were collected from all scheduled appointments during an eight-week period. Variables included were age, gender, appointment time, arrival time, no-shows, appointment type, need for assistance and if it was an early or late appointment. Outcomes were unpunctuality (early and late arrivals) and non-attendance.ResultsOf 1353 appointments, non-attendance rate was 9.5 and 5.1% were late arrivals. Median age increased with increased patient earliness (p < 0.001). Younger age (p = 0.007) and new referrals (p = 0.025) were associated with non-attendance.ConclusionsThe intuition of an association between age and outpatient clinic arrival time was confirmed, thus it is a reality that older patients attend their appointments more frequently and have better punctuality than younger adults. This age effect in outpatient clinics should be considered when developing future simulation models and intervention studies.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Association between age and outpatient clinic arrival time: myth or reality?

Faiz

Kristoffersen

2018

BMC Health Serv Res

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“… 23 24 Another stream of research focuses on the development of systems for identifying users at greatest risk of not attending who can then be supported in order to prevent non-attendance. 25 Support could be in the form of service management tailored to specific groups 26 or patient education and differentiated communication strategies; for example, for low-literacy groups. 27 Finally, it has been suggested simply that more decentralised care should be considered, after years of centralisation and specialisation, where the distance between the users’ homes and the providers in many settings has increased.…”

Section: Discussionmentioning

confidence: 99%

Effectiveness and cost-effectiveness of fining non-attendance at public hospitals: a randomised controlled trial from Danish outpatient clinics

2018

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Objectives Fines have been proposed as means for reducing non-attendance in healthcare. The empirical evidence of the effect of fines is however limited. The objective of this study is to investigate the effectiveness and cost-effectiveness of fining non-attendance at outpatient clinics. Design, participants and setting 1:1 randomised controlled trial of appointments for an outpatient clinic, posted to Danish addresses, between 1 May 2015 and 30 November 2015. Only first appointment for users was included. Healthcare professionals and investigators were masked. Intervention A fine of DKK250 (€34) was issued for non-attendance. Users were informed about the fine in case of non-attendance by the appointment letter, and were able to reschedule or cancel until the appointment. A central administration office administered the fine system. Main outcome measures The main outcome measures were non-attendance of non-cancelled appointments, fine policy administration costs, net of productivity consequences and probability of fining non-attendance being cost-effective over no fining for a range of hypothetical values of reduced non-attendance. Results All of the 6746 appointments included were analysed. Of the 3333 appointments randomised to the fine policy, 130 (5%) of non-cancelled appointments were unattended, and of the 3413 appointments randomised to no-fine policy, 131 (5%) were unattended. The cost per appointment of non-attendance was estimated at DKK 56 (SE 5) in the fine group and DKK47 (SE 4) in the no-fine group, leading to a non-statistically significant difference of DKK10 (95% CI –9 to 22) per appointment attributable to the fine policy. The probability of cost-effectiveness remained around 50%, irrespective of increased values of reduced non-attendance or various alternative assumptions used for sensitivity analyses. Conclusions At a baseline level of around 5%, fining non-attendance does not seem to further reduce non-attendance. Future studies should focus on other means for reduction of non-attendance such as nudging or negative reinforcement. Trial registration number NCT61925912

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“…This percentage of contact and acceptance to participate can be related to the 72‐hour window of the scheduled appointment that we predefined in order to avoid recall bias. In other similar studies, between 15.9% and 69.4% of patients were contacted and included . Patients not included have a higher percentage of males and are older as in the study by Pereira‐Victorio et al The low response rate and the differences between respondents and nonrespondents are consistently observed in most similar publications on causes of absenteeism …”

Section: Discussionmentioning

confidence: 88%

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

Briatore

Tarsetti

Latorre

et al. 2019

Health Planning & Management

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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.

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Dermatology missed appointments: an analysis of outpatient non-attendance in a general hospital's population

Abstract: We propose to identify patients at risk of missed appointments and suggest interventions to overcome this pitfall and improve patient outcomes.

Cited by 10 publications

References 12 publications

Association between age and outpatient clinic arrival time: myth or reality?

Association between age and outpatient clinic arrival time: myth or reality?

Effectiveness and cost-effectiveness of fining non-attendance at public hospitals: a randomised controlled trial from Danish outpatient clinics

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

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