title: Defaulters in general practice: who are they and what can be done about them?
abstract: BACKGROUND
  The study of patients in primary care settings who default on their appointment has been based largely on short-term surveys in individual health centres.
  
  
  OBJECTIVE
  As part of a wider research project into the potential of practice computer appointment systems as a data source, we wanted to explore the aggregate pattern of default.
  
  
  METHODS
  Comprehensive computer appointment data from nine general practices for 1 or 2 years were analysed to explore the pattern of defaulted appointments for doctors and practice nurses.
  
  
  RESULTS
  Around 6.5% of all appointments ended in a default. Default rates were found to be highest amongst young adults and, at a practice level, to be highly correlated with deprivation level. About two-thirds of those who defaulted only did it once during the year. A small core of patients defaulted frequently, but only a quarter of these repeated their behaviour in the following year.
  
  
  CONCLUSIONS
  The discussion suggests that strategies based on educating or punishing defaulters in order to change their behaviour may be of limited effectiveness.
authors.affiliation: Centre for Innovation in Primary Care, Sheffield, UK.
authors.forename: J
authors.initials: J
authors.lastname: Waller
authors.forename: P
authors.initials: P
authors.lastname: Hodgkin
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D001071:Appointments and Schedules; D002648:Child; D002675:Child, Preschool; D005194:Family Practice / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D009819:Office Visits / Q000706:statistics & numerical data; D010349:Patient Compliance / Q000706:statistics & numerical data*; D011216:Practice Management, Medical / Q000458:organization & administration*; D012042:Registries; D017678:Sex Distribution; D016312:Treatment Refusal / Q000706:statistics & numerical data*; D006113:United Kingdom