The impact of Choose and Book on outpatient appointment non-attendances

We evaluate the impact of the introduction from 2005 of an electronic outpatient appointment booking system intended to increase patient choice of hospital and appointment time (Choose and Book (C&B)) on patient non-attendance for first outpatient appointments referred by a patient’s General Practitioner. We estimate fixed effects panel models of the association between changes in GP practice C&B utilisation rates and changes in patient rates of non-attendance at first outpatient appointment between 2004 and 2008. The introduction of C&B was associated with a small reduction of 7.56% (95% CI: 7.22% 8.96%) in nonattendance rates, and a significant decrease in patient cancellations of 4.40% (95% CI: 3.61% – 7.40%). Hospital cancellation rates of first scheduled appointments increased by 14.43% (95% CI: 11.55 – 17.35), but overall attendances still increased by 0.85%. C&B also led to a significant reduction in referral rates of 4.26% (95% CI: 3.75% – 4.78%). The findings suggest that C&B has lead to increased efficiency in health care service provision.