title: The effectiveness of outpatient appointment reminder systems in reducing no-show rates.
abstract: BACKGROUND
  Patients who do not keep physician appointments (no-shows) represent a significant loss to healthcare providers. For patients, the cost includes their dissatisfaction and reduced quality of care. An automated telephone appointment reminder system may decrease the no-show rate. Understanding characteristics of patients who miss their appointments will aid in the formulation of interventions to reduce no-show rates.
  
  
  METHODS
  In an academic outpatient practice, we studied patient acceptance and no-show rates among patients receiving a clinic staff reminder (STAFF), an automated appointment reminder (AUTO), and no reminder (NONE). Patients scheduled for appointments in the spring of 2007 were assigned randomly to 1 of 3 groups: STAFF (n=3266), AUTO (n=3219), or NONE (n=3350). Patients in the STAFF group were called 3 days in advance by front desk personnel. Patients in the AUTO group were reminded of their appointments 3 days in advance by an automated, standardized message. To evaluate patient satisfaction with the STAFF and AUTO, we surveyed patients who arrived at the clinic (n=10,546).
  
  
  RESULTS
  The no-show rates for patients in the STAFF, AUTO, and NONE groups were 13.6%, 17.3%, and 23.1%, respectively (pairwise, P<.01 by analysis of variance for all comparisons). Cancellation rates in the AUTO and STAFF groups were significantly higher than in the NONE group (P<.004). Appointment reminder group, age, visit type, wait time, division specialty, and insurance type were significant predictors of no-show rates. Patients found appointment reminders helpful, but they could not accurately remember whether they received a clinic staff reminder or an automated appointment reminder.
  
  
  CONCLUSIONS
  A clinic staff reminder was significantly more effective in lowering the no-show rate compared with an automated appointment reminder system.
authors.affiliation: Department of Medicine, University of Medicine and Dentistry of New Jersey-Robert Wood Johnson Medical School, New Brunswick, NJ, USA. amayparikh@gmail.com
authors.forename: Amay
authors.initials: A
authors.lastname: Parikh
authors.forename: Kunal
authors.initials: K
authors.lastname: Gupta
authors.forename: Alan C
authors.initials: AC
authors.lastname: Wilson
authors.forename: Karrie
authors.initials: K
authors.lastname: Fields
authors.forename: Nora M
authors.initials: NM
authors.lastname: Cosgrove
authors.forename: John B
authors.initials: JB
authors.lastname: Kostis
mesh_terms: D001071:Appointments and Schedules; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009515:New Jersey; D009819:Office Visits / Q000706:statistics & numerical data*; D010045:Outpatients / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data*; D017010:Reminder Systems / Q000592:standards*