Missed appointment rates in primary care: the importance of site of care.
The objective was to determine whether race, language, or gender concordance between primary care providers (PCPs) and patients is associated with lower missed appointment rates in neighborhood health centers. An additional objective was to determine whether site of care is a determinant of missed appointment rates. In analyses of 74,120 follow-up visits by 13,882 patients, odds ratios for missing an appointment for patients who had language, race or gender concordance with their PCP were 0.90 (95% confidence interval [CI], 0.81-0.99), 0.84 (95% CI, 0.79-0.90) and 1.01 (95% CI, 0.95-1.07) respectively, after adjustment for age, insurance, language, individual PCP open access, sessions per week PCP in practice, and health center. Odds ratios for missing an appointment varied nearly three-fold, depending upon the particular site of care. Race and language concordance between patients and PCPs has only a modest effect on missed appointment rates. Receipt of primary care services at specific neighborhood health centers was the strongest predictor of missed appointment rates in this sample.
Lasser
Karen E
KE
Department of Medicine, Harvard Medical School and the Cambridge Health Alliance, MA, USA. klasser@challiance.org
Mintzer
Ira L
IL
Lambert
Astrid
A
Cabral
Howard
H
Bor
David H
DH
D000293:Adolescent; D000328:Adult; D000368:Aged; D001071:Appointments and Schedules; D003151:Community Health Centers; D005260:Female; D006801:Humans; D008297:Male; D008404:Massachusetts; D008875:Middle Aged; D011320:Primary Health Care / Q000458:organization & administration*