Lead Time to Appointment and No-Show Rates for New and Follow-up Patients in an Ambulatory Clinic

Health Care Manag (Frederick). 2017 Jan/Mar;36(1):4-9. doi: 10.1097/HCM.0000000000000148.

Abstract

High rates of no-shows in outpatient clinics are problematic for revenue and for quality of patient care. Longer lead time to appointment has variably been implicated as a risk factor for no-shows, but the evidence within pediatric clinics is inconclusive. The goal of this study was to estimate no-show rates and test for association between appointment lead time and no-show rates for new and follow-up patients. Analyses included 534 new and 1920 follow-up patients from pulmonology and gastroenterology clinics at a freestanding children's hospital. The overall rate of no-shows was lower for visits scheduled within 0 to 30 days compared with 30 days or more (23% compared with 47%, P < .0001). Patient type significantly modified the association of appointment lead time; the rate of no-shows was higher (30%) among new patients compared with (21%) follow-up patients with appointments scheduled within 30 days (P = .004). For appointments scheduled 30 or more days' lead time, no-show rates were statistically similar for new patients (46%) and follow-up patients (0.48%). Time to appointment is a risk factor associated with no-shows, and further study is needed to identify and implement effective approaches to reduce appointment lead time, especially for new patients in pediatric subspecialties.

MeSH terms

  • Aftercare / statistics & numerical data*
  • Ambulatory Care Facilities / economics*
  • Ambulatory Care Facilities / organization & administration
  • Appointments and Schedules*
  • Cross-Sectional Studies
  • Humans
  • No-Show Patients / economics
  • No-Show Patients / statistics & numerical data*
  • Patient Compliance / statistics & numerical data
  • Pediatrics
  • Reminder Systems / statistics & numerical data
  • Retrospective Studies
  • Risk Factors
  • Time Factors