RESUMO
Missed clinic appointments lead to decreased patient access, worse patient outcomes, and increased healthcare costs. The goal of this pilot study was to identify reasons for and risk factors associated with missed pediatric neurology outpatient appointments ("no-shows"). This was a prospective cohort study of patients scheduled for 1 week of clinic. Data on patient clinical and demographic information were collected by record review; data on reasons for missed appointments were collected by phone interviews. Univariate and multivariate analyses were conducted using chi-square tests and multiple logistic regression to assess risk factors for missed appointments. Fifty-nine (25%) of 236 scheduled patients were no-shows. Scheduling conflicts (25.9%) and forgetting (20.4%) were the most common reasons for missed appointments. When controlling for confounding factors in the logistic regression, Medicaid (odds ratio 2.36), distance from clinic, and time since appointment was scheduled were associated with missed appointments. Further work in this area is needed.
Assuntos
Neurologia/estatística & dados numéricos , Pacientes não Comparecentes/estatística & dados numéricos , Pacientes Ambulatoriais/estatística & dados numéricos , Pediatria/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , Feminino , Humanos , Entrevistas como Assunto , Modelos Logísticos , Masculino , Medicaid , Análise Multivariada , Pacientes não Comparecentes/psicologia , Pacientes Ambulatoriais/psicologia , Projetos Piloto , Estudos Prospectivos , Fatores de Risco , Fatores de Tempo , Estados UnidosRESUMO
OBJECTIVE: Missed appointments ("no-shows") represent an important source of lost revenue for academic medical centers. The goal of this study was to examine the costs of "no-shows" at an academic pediatric neurology outpatient clinic. METHODS: This was a retrospective cohort study of patients who missed appointments at an academic pediatric neurology outpatient clinic during 1 academic year. Revenue lost was estimated based on average reimbursement for different insurance types and visit types. RESULTS: The yearly "no-show" rate was 26%. Yearly revenue lost from missed appointments was $257,724.57, and monthly losses ranged from $15,652.33 in October 2013 to $27,042.44 in January 2014. CONCLUSIONS: The yearly revenue lost from missed appointments at the academic pediatric neurology clinic represents funds that could have been used to improve patient access and care. Further work is needed to develop strategies to decrease the no-show rate to decrease lost revenue and improve patient care and access.