Who Will Show? Predicting Missed Visits Among Patients in Routine HIV Primary Care in the United States

AIDS Behav. 2019 Feb;23(2):418-426. doi: 10.1007/s10461-018-2215-1.


Missed HIV medical visits predict poor clinical outcomes. We sought to identify patients at high risk of missing visits. We analyzed 2002-2014 data from six large US HIV clinics. At each visit, we predicted the likelihood of missing the next scheduled visit using demographic, clinical, and patient-reported psychosocial variables. Overall, 10,374 participants contributed 105,628 HIV visits. For 17% of visits, the next scheduled appointment was missed. The strongest predictor of a future missed visit was past-year missed visits. A model with only this predictor had area under the receiver operator curve = 0.65; defining "high risk" as those with any past-year missed visits had 73% sensitivity and 51% specificity in correctly identifying a future missed visit. Inclusion of other clinical and psychosocial predictors only slightly improved performance. Past visit attendance can identify those at increased risk for future missed visits, allowing for proactive allocation of resources to those at greatest risk.

Keywords: Appointment attendance; HIV; Missed visits; Predictive models; Retention in care.

MeSH terms

  • Adult
  • Appointments and Schedules
  • Female
  • Forecasting / methods*
  • HIV Infections / epidemiology*
  • HIV Infections / psychology
  • Health Behavior
  • Humans
  • Male
  • Middle Aged
  • Office Visits / statistics & numerical data*
  • Patient Acceptance of Health Care / statistics & numerical data*
  • Patient Compliance / statistics & numerical data*
  • Primary Health Care
  • United States / epidemiology
  • Young Adult