title: Depression and literacy are important factors for missed appointments.
abstract: Multiple variables are related to missed clinic appointments. However, the prevalence of missed appointments is still high suggesting other factors may play a role. The purpose of this study was to investigate the relationship between missed appointments and multiple variables simultaneously across a health care system, including patient demographics, psychiatric symptoms, cognitive functioning and literacy status. Chart reviews were conducted on 147 consecutive patients who were seen by a primary care psychologist over a six month period and completed measures to determine levels of depression, anxiety, sleep, cognitive functioning and health literacy. Demographic information and rates of missed appointments were also collected from charts. The average rate of missed appointments was 15.38%. In univariate analyses, factors related to higher rates of missed appointments included younger age (p = .03), lower income (p = .05), probable depression (p = .05), sleep difficulty (p = .05) and limited reading ability (p = .003). There were trends for a higher rate of missed appointments for patients identifying as black (p = .06), government insurance (p = .06) and limited math ability (p = .06). In a multivariate model, probable depression (p = .02) and limited reading ability (p = .003) were the only independent predictors. Depression and literacy status may be the most important factors associated with missed appointments. Implications are discussed including regular screening for depression and literacy status as well as interventions that can be utilized to help improve the rate of missed appointments.
authors.affiliation: a Henry Ford Health System , Behavioral Health, Henry Ford Hospital , Detroit , MI , USA.|b Internal Medicine , Henry Ford Hospital , Detroit , MI , USA.
authors.forename: Lisa Renee
authors.initials: LR
authors.lastname: Miller-Matero
authors.affiliation: a Henry Ford Health System , Behavioral Health, Henry Ford Hospital , Detroit , MI , USA.|b Internal Medicine , Henry Ford Hospital , Detroit , MI , USA.
authors.forename: Kalin Burkhardt
authors.initials: KB
authors.lastname: Clark
authors.affiliation: a Henry Ford Health System , Behavioral Health, Henry Ford Hospital , Detroit , MI , USA.|b Internal Medicine , Henry Ford Hospital , Detroit , MI , USA.
authors.forename: Carly
authors.initials: C
authors.lastname: Brescacin
authors.affiliation: a Henry Ford Health System , Behavioral Health, Henry Ford Hospital , Detroit , MI , USA.
authors.forename: Hala
authors.initials: H
authors.lastname: Dubaybo
authors.affiliation: b Internal Medicine , Henry Ford Hospital , Detroit , MI , USA.
authors.forename: David E
authors.initials: DE
authors.lastname: Willens
mesh_terms: D000328:Adult; D001741:Black or African American; D000368:Aged; D001007:Anxiety; D001071:Appointments and Schedules; D003710:Demography; D003863:Depression; D003866:Depressive Disorder; D005260:Female; D006801:Humans; D000067010:Literacy; D008297:Male; D008485:Medical Audit; D008875:Middle Aged; D010349:Patient Compliance / Q000523:psychology*; D011320:Primary Health Care
keywords: Depression; integrated care; literacy; missed appointments