Missed appointments in an adolescent outpatient clinic: descriptive analyses of consultations over 8 years.
OBJECTIVE
Missed appointments represent an important medical and economical issue. Few studies on the subject are reported in the literature, particularly regarding adolescents. Our aim was to characterize missed and cancelled appointments in a multidisciplinary outpatient clinic for adolescents, to assess the effectiveness of a policy aimed at reducing missed appointments by introducing payment for those missed appointments not cancelled in advance, and to compare the rates between staff and resident physicians.


METHODS
A total of 32,816 consultations (representing 35 patients aged 12-20 years, 82.4% females) between 1999 and 200 were analysed.


RESULTS
The missed appointment rate was 11.8% whilst another 10.9% were cancellations. Females cancelled more than males (11.3% vs. 8.4%, AOR 1.31, 99% CI 1.08-1.59), but there was no difference for missed appointments (11.6% vs. 12.3%, AOR 0.88, 99% CI 0.61-1.08). April and June to October (vacation months) were associated with more missed appointments. Globally mornings had higher rates of missed appointments than afternoons (13.6% vs. 11.2%, AOR 1.25, 99% CI 1.11-1.40). There was a slight difference in missed appointment rates between staff physicians and residents (10.4%; 11.8%, AOR 1.20, 99% CI 1.08-1.33). Missed appointment rates before and after the new policy on missed appointments were similar (1999-2003: 11.9%; 2004-2006: 11.6%, AOR 0.96, 99% CI 0.83-1.10). Conversely, cancellation rates increased from 8.4% (1999-2003) to 14.5% (2004-2006) (AOR 1.83, 99% CI 1.63-2.05).


CONCLUSIONS
Attendance rates among adolescents show variations depending on vacation and school hours. Being attentive to these factors could help prevent missed appointments. Although having to pay for missed appointments does not increase attendance, it increases cancellations with the advantage that the appointment can be rescheduled.
Research Group on Adolescent Health, Institute of Social and Preventive Medicine, University Hospital Center of Vaud and University of Lausanne, Bugnon 17, CH-1005 Lausanne, Switzerland.
Vincent
V
Chariatte
Pierre-André
PA
Michaud
André
A
Berchtold
Christina
C
Akré
Joan-Carles
JC
Suris
D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services; D000328:Adult; D001071:Appointments and Schedules; D002648:Child; D003266:Continuity of Patient Care; D005249:Fees and Charges; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008330:Management Audit; D016134:Organizational Policy; D010044:Outpatient Clinics, Hospital / Q000191:economics; D010349:Patient Compliance; D010817:Physician-Patient Relations