RESUMEN
The purpose of this research was to examine patient characteristics that may be associated with appointment no-show rates, and to explore patients' perspectives of missed appointments at a community health centre that primarily serves low-income individuals. This mixed-method, cross-sectional study is based upon data collected from a community health centre in Southeastern Tennessee in the United States that provided preventative medical, behavioural health and dental care. Authors utilised de-identified electronic health record (EHR) information on no-show occurrence and sociodemographic characteristics of all patients served by the clinic (n = 1,243), as well as completed mixed method patient interviews a sub-sample of those receiving service from the clinic (n = 30). EHR data were pulled from clinic visits occurring during July-November 2017, and patient interviews were completed January-March 2018. Measures were developed by the authors and clinic administrators after a thorough review of existing literature. HER data demonstrated an association between higher no-show rate and younger patients was identified and Black or African American patients had higher no-show rate than White patients. However, no differences in no-show rate existed between male and female participants or when examining patients' location. Based on interview data, patients were generally satisfied with their services or providers, but some indicated dissatisfaction. Patients typically missed appointments due to personal issues and societal barriers. Findings support the need for clinics to consider ways to support patients facing competing demands for their time or those facing more resource constraints. Recommendations for research include examining long-term health outcomes of clients who are experiencing no-shows. Changes in practice or procedures were also noted, such as providing transportation, elevating awareness and access to social services, ensuring that that social care workers are reaching out to clients with higher no-shows and educating clients on the importance of preventative care.