Toward a better understanding of dental appointment-keeping behavior.
OBJECTIVE
Broken appointments cause adverse outcomes in healthcare systems: They interrupt continuity of care, waste resources, affect workflow, and reduce population-wide access to care. A better understanding of dental appointment-keeping behavior would support efforts toward designing novel interventions aimed at reducing rates of broken appointments.


METHODS
The authors conducted a conceptual review of quantitative and qualitative research on dental appointment-keeping in the United States.


RESULTS
Research in this area is limited. Providers tend to use a blunt instrument to improve appointment-keeping: a system of reminder calls. There is evidence that patients with higher rates of broken dental appointments are the very ones who are most in need of care. Appointment-keeping barriers are multifactorial and related to social issues. They can be described as falling into three overlapping categories: psychological barriers, structural barriers, and health literacy barriers.


CONCLUSIONS
Appointment-keeping interventions could simultaneously address social factors that exacerbate illness and improve workflow and finances. There arises an opportunity to design innovative patient-centered interventions tailored to particular barriers.
School of Social Work, University of Michigan, Ann Arbor, MI, USA.
Adrienne
A
Lapidos
School of Social Work, University of Michigan, Ann Arbor, MI, USA.
H Luke
HL
Shaefer
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA.
Anne
A
Gwozdek
D001071:Appointments and Schedules; D003729:Dental Care / Q000706:statistics & numerical data*; D006801:Humans; D010349:Patient Compliance / Q000523:psychology / Q000706:statistics & numerical data*; D017010:Reminder Systems
access; behavioral science; broken appointments; disparities; psychosocial aspects of oral health