title: Lead Time to Appointment and No-Show Rates for New and Follow-up Patients in an Ambulatory Clinic.
abstract: High rates of no-shows in outpatient clinics are problematic for revenue and for quality of patient care. Longer lead time to appointment has variably been implicated as a risk factor for no-shows, but the evidence within pediatric clinics is inconclusive. The goal of this study was to estimate no-show rates and test for association between appointment lead time and no-show rates for new and follow-up patients. Analyses included 534 new and 1920 follow-up patients from pulmonology and gastroenterology clinics at a freestanding children's hospital. The overall rate of no-shows was lower for visits scheduled within 0 to 30 days compared with 30 days or more (23% compared with 47%, P < .0001). Patient type significantly modified the association of appointment lead time; the rate of no-shows was higher (30%) among new patients compared with (21%) follow-up patients with appointments scheduled within 30 days (P = .004). For appointments scheduled 30 or more days' lead time, no-show rates were statistically similar for new patients (46%) and follow-up patients (0.48%). Time to appointment is a risk factor associated with no-shows, and further study is needed to identify and implement effective approaches to reduce appointment lead time, especially for new patients in pediatric subspecialties.
authors.affiliation: Author Affiliations: Sleep Disorders Center, Department of Pediatric Pulmonology (Dr Drewek), and Department of Research (Dr Mirea), and Barrow Neurological Institute and Neurosurgery, (Dr Adelson) Phoenix Children's Hospital, Arizona.
authors.forename: Rupali
authors.initials: R
authors.lastname: Drewek
authors.forename: Lucia
authors.initials: L
authors.lastname: Mirea
authors.forename: P David
authors.initials: PD
authors.lastname: Adelson
mesh_terms: D000359:Aftercare / Q000706:statistics & numerical data*; D000554:Ambulatory Care Facilities / Q000191:economics* / Q000458:organization & administration; D001071:Appointments and Schedules; D003430:Cross-Sectional Studies; D006801:Humans; D000067455:No-Show Patients / Q000191:economics / Q000706:statistics & numerical data*; D010349:Patient Compliance / Q000706:statistics & numerical data; D010372:Pediatrics; D017010:Reminder Systems / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors