Evaluation of Clinical No-Show Rates in the Setting of an Outpatient Internal Medicine Residency Clinic

Author:

Soos Michael1,Cobb Alexander1,Patel Parag1,Mandiga Hemalata1,Ghose Amit1,Clark Shane1

Affiliation:

1. McLaren Greater Lansing, Lansing, MI

Abstract

A no-show appointment is clinically defined as a scheduled appointment in which a patient fails to attend without prior notification to the provider or staff. In primary care clinics, no-show rates have been shown to range from 15% to 30%. Smaller studies have shown that interventions including phone calls, emails or text message reminders can reduce no-show rates.1–9 Our retrospective review sought to evaluate a similar intervention performed at the Multispecialty Residency Clinic (MSC). A test of two proportions was performed to evaluate the effect of a 24-hour reminder phone call. The no-show rate before initiating a 24-hour phone call was 17.8%, and following the intervention this rate improved to 16%, an observed reduction of 1.9% with a 95% confidence interval (CI) from 0.1% to 3%, p = 0.003. New patient encounters, established patient visits and cancellations were analyzed as secondary endpoints to further evaluate the effects of a reminder phone call. Our retrospective analysis is the largest to date regarding the effectiveness of utilizing phone call reminders to reduce no-show rates in the setting of a residency clinic and has confirmed a significant 2% reduction in no-show appointments.

Publisher

The American College of Osteopathic Family Physicians - ACOFP

Subject

Family Practice

Reference17 articles.

1. Molfenter T. Reducing appointment no-shows: going from theory to practice. Subst Use Misuse. 2013;48(9):743–749. doi:10.3109/10826084.2013.7870982.

2. Berg BP, Murr M, Chermak D, et al. Estimating the cost of no-shows and evaluating the effects of mitigation strategies. Med Decis Making. 2013;33(8):976–985. doi:10.1177/0272989X134781943.

3. Hashim MJ, Franks P, Fiscella K. Effectiveness of telephone reminders in improving rate of appointments kept at an outpatient clinic: a randomized controlled trial. J Am Board Fam Pract. 2001;14(3):193–19.

4. Hixon AL, Chapman RW, Nuovo J. Failure to keep clinic appointments: implications for residency education and productivity. Fam Med. 1999;31:627–30.

5. George A, Rubin G. Non-attendance in general practice: a systematic review and its implications for access to primary health care. Fam Pract. 2003;20(2):178–84.

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