Missed appointments and Medicaid managed care.
OBJECTIVE
To compare the demographic characteristics of patients who miss appointments with those who do not and to identify subgroups who would benefit from specific interventions for improving attendance.


METHODS
Retrospective cohort study of an 18-month period.


METHODS
An urban primary care practice.


METHODS
A random sample (N = 477) of patients who were seen at least twice during the study period.


METHODS
Number of missed visits and kept visits, insurer, age, sex, race, ZIP code, and diagnoses.


RESULTS
Of the established patients, 48% missed 1 or more visits. Patients in managed care programs, private and Medicaid, were likely to have missed more visits during the study period than those not in managed care programs (P < .001). Medicaid managed care patients had also scheduled more visits. Significantly higher rates of missed appointments were found in patients aged 19 to 35 years (P = .02), blacks (P < .001), patients in Medicaid managed care programs (P < .001), and patients who scheduled more visits (P < .001). After adjusting for age, race, and sex, Medicaid managed care insurance remained a significant (P < .01) predictor of rate of missed appointments.


CONCLUSIONS
Patients in managed care programs missed more appointments. Patients in Medicaid managed care programs scheduled more appointments and had higher rates of missed appointments than their counterparts in other insurance groups.
Majeroni
B A
BA
State University of New York at Buffalo, USA. bmajeron@ubmedb.buffalo.edu
Cowan
T
T
Osborne
J
J
Graham
R P
RP
D000328:Adult; D017677:Age Distribution; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D008484:Medicaid; D008875:Middle Aged; D015999:Multivariate Analysis; D017149:Private Sector; D012044:Regression Analysis; D012189:Retrospective Studies; D017678:Sex Distribution; D014481:United States; D014505:Urban Population