Technology, Primary Care and Appointment Attendance: Investigating how the use of technology can reduce missed appointments at a GP practice: a quantitative analysis (Preprint)

Abstract

Technology is playing a major role in Primary care (PC), with short message service (SMS) systems being hailed as the answer to reducing the number of missed appointments. Research in this area has been more qualitative, focusing on whether SMS users and receivers, have positive or negative views of the SMS systems. This research paper looks at the appointment data from a large independent GP Practice in Wrexham, with circa 15,000 patients. The data covers a ten-year period from 1st September 2010 to 31st March 2020. In this period there were a total of 9,191 missed appointments out of a possible 572,794 appointments booked.

The aim of the research is to determine if SMS messaging systems reduce the number of missed appointments.

The data was gathered using SQL query reports run on EMIS web and checked for accuracy by comparing the numbers from the reports with the appointment diary. The GP appointment data was confirmed as accurate, but the nurse appointment data did not match up, therefore only the GP appointments were looked at.

The total number of missed appointments pre-SMS (5848) and post-SMS (3343) were analysed using Mann-Whitney (MW) tests for yearly, quarterly, and monthly data. The results of the tests showed that there was a significant reduction (43%) in the number of missed appointments after the introduction of SMS messaging. MW tests looking at female and male data also showed a significant decrease in the number of missed appointments. Comparing the data of female and male for any difference between the genders clearly showed no significant difference in missed appointments. The data was furthered categorized in age ranges of ten years or five years and analysed using Kruskal Wallis (KW) tests. Comparing the data for missed appointments, the age range that significantly missed more appointments was 20 – 25 years. The age range that had the lowest percentage of missed appointments was 70 – 75 years. The female data showed that the age range that missed significantly more appointments was also 20 – 25 years but the age range that missed the lowest percentage of appointments was 65 – 70 years. The male data showed that the age range that missed significantly more appointments was 35 – 40 years with the lowest percentage of missed appointments in the age range of 75 – 80 years.

The research study has conclusively shown that technology has reduced the number of GP missed appointments. The introduction of SMS messaging significantly reduced the did not attends (DNAs) and enabled the patients to cancel the appointment in good time. The results have also shown no difference between female and male DNAs’, showing that gender does not influence the missed appointment data.