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.