Failed appointments in residency practices: who misses them and what providers are most affected?

BACKGROUND Missed appointments can affect patient health, disrupt schedules, and result in poor utilization of resources, increased workload for staff and physicians, and lost learning opportunities for residents in training programs. METHODS The setting was an established community-hospital-based family practice residency practice averaging 25,000 outpatient visits per year in a small northern New England town. Data from a computer-scheduling system and hospital mainframe, as well as demographic and other information contained in billing records and patient schedules, were abstracted for patients who scheduled 3962 appointments on 36 sampled days during 1995. RESULTS The missed appointment rate during the study period was 6.7 percent. Characteristics associated with missed appointments were younger patient age (17 to 30 years), Medicaid coverage or lack of health insurance, and appointments scheduled with first-year residents or medical students. CONCLUSIONS Attention should be given to those patients most likely to miss appointments and, in training programs, to patients seeing first-year residents and medical students. It is possible that our relatively low missed appointment rate overall resulted from the nature of the practice and its environment.