3035.0: Monday, October 22, 2001 - Board 3

Abstract #23888

Factors related to the failure to keep appointments in an underserved population at a federally funded Community Health Center

Rebecca Kinney, MPH1, Judith Savageau, MPH1, Celeste Lemay, RN, BSN1, Suzanne Cashman, ScD2, Ellen Long-Middleton, RN, PhD3, and Annette Hanson, MD4. (1) Family Medicine and Community Health, University of Massachusetts - Worcester, 55 Lake Avenue North, Worcester, MA 01655, 508-856-6470, rebecca.kinney@umassmed.edu, (2) Family Medicine and Community Health, University of Massachusetts Medical School, 55 Lake Ave North, Worcester, MA 01655, (3) Graduate School of Nursing, University of Massachusetts - Worcester, 55 Lake Avenue North, Worcester, MA 01655, (4) Office of Clinical Affairs, Massachusetts Division of Medical Assistance, 600 Washington Street, Boston, MA 02111

Patients' failure to keep appointments may contribute to poor health status while reducing providers' effectiveness and productivity. Chart audits of 465 adult patients who received primary health care at a federally funded,community health center one week in February 1999 were conducted. Forty-eight percent of patients (225/464) failed to keep at least one appointment (i.e., did not show up/did not call to reschedule) during the twelve-month study timeframe. Failure to keep an appointment was related to the patient's insurance coverage, age, gender, ethnicity, and chronic illness diagnosis. Approximately one-half of patients whose primary insurance was Medicaid (52%) or Medicare (46%) missed one or more appointments during this period. Slightly higher, but not statistically significant (54%), were patients who paid for care out-of-pocket and failed to keep at least one appointment. Patients were more likely to miss appointments if they were young (under 50 years old), female, and of Hispanic ethnicity. Although patients with chronic physical problems were more likely to keep appointments than their counterparts who did not have such conditions, individuals diagnosed with any type of chronic psychological condition were more likely to fail to keep at least one appointment during the study period. The number of missed appointments did not vary significantly by provider type. Findings suggest that patients who fail to keep scheduled appointments differ from their appointment-keeping counterparts by sociodemographic characteristic and diagnostic category. Health centers serving a low-income population need to examine patient failure to keep appointment data and customize interventions appropriate to selected subgroups.

Learning Objectives: Patients' failure to keep appointments may contribute to poor health status while reducing providers' effectiveness and productivity.

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 129th Annual Meeting of APHA