Cargando…

Reduction of missed appointments at an urban primary care clinic: a randomised controlled study

BACKGROUND: Missed appointments are known to interfere with appropriate care and to misspend medical and administrative resources. The aim of this study was to test the effectiveness of a sequential intervention reminding patients of their upcoming appointment and to identify the profile of patients...

Descripción completa

Detalles Bibliográficos
Autores principales: Junod Perron, Noelle, Dominicé Dao, Melissa, Kossovsky, Michel P, Miserez, Valerie, Chuard, Carmen, Calmy, Alexandra, Gaspoz, Jean-Michel
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984453/
https://www.ncbi.nlm.nih.gov/pubmed/20973950
http://dx.doi.org/10.1186/1471-2296-11-79
_version_ 1782192092517236736
author Junod Perron, Noelle
Dominicé Dao, Melissa
Kossovsky, Michel P
Miserez, Valerie
Chuard, Carmen
Calmy, Alexandra
Gaspoz, Jean-Michel
author_facet Junod Perron, Noelle
Dominicé Dao, Melissa
Kossovsky, Michel P
Miserez, Valerie
Chuard, Carmen
Calmy, Alexandra
Gaspoz, Jean-Michel
author_sort Junod Perron, Noelle
collection PubMed
description BACKGROUND: Missed appointments are known to interfere with appropriate care and to misspend medical and administrative resources. The aim of this study was to test the effectiveness of a sequential intervention reminding patients of their upcoming appointment and to identify the profile of patients missing their appointments. METHODS: We conducted a randomised controlled study in an urban primary care clinic at the Geneva University Hospitals serving a majority of vulnerable patients. All patients booked in a primary care or HIV clinic at the Geneva University Hospitals were sent a reminder 48 hrs prior to their appointment according to the following sequential intervention: 1. Phone call (fixed or mobile) reminder; 2. If no phone response: a Short Message Service (SMS) reminder; 3. If no available mobile phone number: a postal reminder. The rate of missed appointment, the cost of the intervention, and the profile of patients missing their appointment were recorded. RESULTS: 2123 patients were included: 1052 in the intervention group, 1071 in the control group. Only 61.7% patients had a mobile phone recorded at the clinic. The sequential intervention significantly reduced the rate of missed appointments: 11.4% (n = 122) in the control group and 7.8% (n = 82) in the intervention group (p < 0.005), and allowed to reallocate 28% of cancelled appointments. It also proved to be cost effective in providing a total net benefit of 1846. - EUR/3 months. A satisfaction survey conducted with 241 patients showed that 93% of them were not bothered by the reminders and 78% considered them to be useful. By multivariate analysis, the following characteristics were significant predictors of missed appointments: younger age (OR per additional decade 0.82; CI 0.71-0.94), male gender (OR 1.72; CI 1.18-2.50), follow-up appointment >1year (OR 2.2; CI: 1.15-4.2), substance abuse (2.09, CI 1.21-3.61), and being an asylum seeker (OR 2.73: CI 1.22-6.09). CONCLUSION: A practical reminder system can significantly increase patient attendance at medical outpatient clinics. An intervention focused on specific patient characteristics could further increase the effectiveness of appointment reminders.
format Text
id pubmed-2984453
institution National Center for Biotechnology Information
language English
publishDate 2010
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-29844532010-11-19 Reduction of missed appointments at an urban primary care clinic: a randomised controlled study Junod Perron, Noelle Dominicé Dao, Melissa Kossovsky, Michel P Miserez, Valerie Chuard, Carmen Calmy, Alexandra Gaspoz, Jean-Michel BMC Fam Pract Research Article BACKGROUND: Missed appointments are known to interfere with appropriate care and to misspend medical and administrative resources. The aim of this study was to test the effectiveness of a sequential intervention reminding patients of their upcoming appointment and to identify the profile of patients missing their appointments. METHODS: We conducted a randomised controlled study in an urban primary care clinic at the Geneva University Hospitals serving a majority of vulnerable patients. All patients booked in a primary care or HIV clinic at the Geneva University Hospitals were sent a reminder 48 hrs prior to their appointment according to the following sequential intervention: 1. Phone call (fixed or mobile) reminder; 2. If no phone response: a Short Message Service (SMS) reminder; 3. If no available mobile phone number: a postal reminder. The rate of missed appointment, the cost of the intervention, and the profile of patients missing their appointment were recorded. RESULTS: 2123 patients were included: 1052 in the intervention group, 1071 in the control group. Only 61.7% patients had a mobile phone recorded at the clinic. The sequential intervention significantly reduced the rate of missed appointments: 11.4% (n = 122) in the control group and 7.8% (n = 82) in the intervention group (p < 0.005), and allowed to reallocate 28% of cancelled appointments. It also proved to be cost effective in providing a total net benefit of 1846. - EUR/3 months. A satisfaction survey conducted with 241 patients showed that 93% of them were not bothered by the reminders and 78% considered them to be useful. By multivariate analysis, the following characteristics were significant predictors of missed appointments: younger age (OR per additional decade 0.82; CI 0.71-0.94), male gender (OR 1.72; CI 1.18-2.50), follow-up appointment >1year (OR 2.2; CI: 1.15-4.2), substance abuse (2.09, CI 1.21-3.61), and being an asylum seeker (OR 2.73: CI 1.22-6.09). CONCLUSION: A practical reminder system can significantly increase patient attendance at medical outpatient clinics. An intervention focused on specific patient characteristics could further increase the effectiveness of appointment reminders. BioMed Central 2010-10-25 /pmc/articles/PMC2984453/ /pubmed/20973950 http://dx.doi.org/10.1186/1471-2296-11-79 Text en Copyright ©2010 Junod Perron et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Junod Perron, Noelle
Dominicé Dao, Melissa
Kossovsky, Michel P
Miserez, Valerie
Chuard, Carmen
Calmy, Alexandra
Gaspoz, Jean-Michel
Reduction of missed appointments at an urban primary care clinic: a randomised controlled study
title Reduction of missed appointments at an urban primary care clinic: a randomised controlled study
title_full Reduction of missed appointments at an urban primary care clinic: a randomised controlled study
title_fullStr Reduction of missed appointments at an urban primary care clinic: a randomised controlled study
title_full_unstemmed Reduction of missed appointments at an urban primary care clinic: a randomised controlled study
title_short Reduction of missed appointments at an urban primary care clinic: a randomised controlled study
title_sort reduction of missed appointments at an urban primary care clinic: a randomised controlled study
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2984453/
https://www.ncbi.nlm.nih.gov/pubmed/20973950
http://dx.doi.org/10.1186/1471-2296-11-79
work_keys_str_mv AT junodperronnoelle reductionofmissedappointmentsatanurbanprimarycareclinicarandomisedcontrolledstudy
AT dominicedaomelissa reductionofmissedappointmentsatanurbanprimarycareclinicarandomisedcontrolledstudy
AT kossovskymichelp reductionofmissedappointmentsatanurbanprimarycareclinicarandomisedcontrolledstudy
AT miserezvalerie reductionofmissedappointmentsatanurbanprimarycareclinicarandomisedcontrolledstudy
AT chuardcarmen reductionofmissedappointmentsatanurbanprimarycareclinicarandomisedcontrolledstudy
AT calmyalexandra reductionofmissedappointmentsatanurbanprimarycareclinicarandomisedcontrolledstudy
AT gaspozjeanmichel reductionofmissedappointmentsatanurbanprimarycareclinicarandomisedcontrolledstudy