Evaluating the Factors that Influence Missed Appointments at a Community Health Center
Abstract
Background. Patient missed appointment rates at federally qualified health centers has had a significant influence on staff and patient workflow. Failed appointments cause resources and time to be wasted, and health issues to remain untreated. Most reasons for missed appointments commonly include lack of transportation, forgetfulness, demographic factors, financial barriers, and other obligations. Objective. The patient no show rate at Health Care Collaborative (HCC) Network has caused a disturbance to workflow for clinical staff. This evaluation was completed to determine what factors influence the failed appointment rate and how said rate influences clinical staff. After determining common barriers that patients may face, possible intervention strategies were developed. The purpose of this evaluation is to provide recommendations to the HCC Network to reduce the patient no-show and missed appointment rate moving forward. Recommendations were based on perspectives from both patient and staff surveys. Design. Patients who attended an HCC Network Clinic between March 1st 2022 and March 17th 2022 were asked to participate in an in-person survey. Patients that missed scheduled appointments between March 1sts 2022 and March 17th were called and asked to complete the same survey via phone. A total of 68 patients were asked to complete the survey and 43 patients agreed to participate. A staff survey was also sent out to 59 clinical staff members to obtain their perspectives on the no-show and missed appointment rate. 31 staff completed the survey. A multivariate analysis was conducted to determine what factors influenced a missed appointment. Results. The following are predictors of missed appointments: age (t=2.63, p=0.01), employment status (t = 2.6, p=0.01), receiving healthcare reminders (t= 2.87, p=0.01), long wait times (t= -2.88, p=0.01) and whether the patient drives their own car (t==2.97, p=0.04). Barriers that were reported from patients included transportation, location, cost/insurance, employment status and forgetfulness. Conclusion. Interventions to reduce the missed appointment rate at the HCC Network should focus on including strategies to help reduce barriers that were most reported. Possible intervention strategies include an interactive patient reminder call, confirming with patients that they have transportation to and from their appointment, and reducing long wait times with a patient portal option.
Degree
D.N.P.
Thesis Department
Rights
Open Access (fully available)
Copyright retained by author