Factors of Missed Appointments at a Medical Center in Taiwan

• Main Authors: Wen-Chien Tsai, 蔡文茜
• Other Authors: Tzen-Ji Chen
• Format: Others
• Language: en_US
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/s3fu8x

碩士 === 國立陽明大學 === 醫務管理研究所 === 106 === Background: Missed appointments mean appointments neither attended nor cancelled by patients. Missed appointments belong to one of important subjects of hospital management, because they would incur the inactivity of medical professionals and devices, occupy the health resources for other patients, and thus impair the quality of healthcare services. The aim of this study was to explore the factors of missed appointments at the outpatient department of an academic medical center in Taiwan. Methods: This was a cross-sectional study based on registration records of an academic medical center in northern Taiwan in 2015. Fifteen variables of patients, appointments and weathers were taken into analysis. Logistic regression was used to calculate the adjusted odds ratio of each variable. For non-first visits, we further built a logistic regression model with the 5 most influential variables and the personal attendance pattern of the previous 3 appointments. Results: Of 2,132,577 eligible appointments in 2015, the overall no-show rate was 16.9%. The influential factors included: (1) patient characteristics: younger than 40 years, less than or equal to 6 visits and a no-show rate between 50% and 75% in the previous year; (2) appointment characteristics: Saturdays, evenings, on the last third of the waiting list, only one appointment on the same day, online appointments, appointment-to-visit intervals in 7-14 days, appointments to obstetrics/gynecology or iv pediatrics, first-time appointments, and the interval since the last visit in less than 7 days; and (3) weather characteristics: warm weathers and heavy rains. For non-first appointments, the influences in decreasing order were heavy rain, shorter interval between appointed visit and the previous visit to the same department, higher no-show rate in the previous year, total absence in the personal attendance pattern of the previous 3 appointments, longer appointment wait time, and young people. Conclusion: The factors of missed appointments were multi-faceted. Further measures could be undertaken accordingly to enhance healthcare efficiency, service quality and patient’s satisfaction. Key Words: Appointments and schedules; No-show patients; Outpatient clinics, hospital; Taiwan