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Showing content from http://www.ncbi.nlm.nih.gov/pubmed/27503436 below:

Targeted Reminder Phone Calls to Patients at High Risk of No-Show for Primary Care Appointment: A Randomized Trial

Randomized Controlled Trial

. 2016 Dec;31(12):1460-1466. doi: 10.1007/s11606-016-3813-0. Epub 2016 Aug 8. Targeted Reminder Phone Calls to Patients at High Risk of No-Show for Primary Care Appointment: A Randomized Trial

Affiliations

¹ Department of Medicine, Division of General Internal Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. sshah@mgh.harvard.edu.
² Massachusetts General Physicians Organization, Massachusetts General Hospital, 50 Staniford Street (940-J), Boston, MA, 02114, USA. sshah@mgh.harvard.edu.
³ Department of Medicine, Lab of Computer Science, Massachusetts General Hospital, Boston, MA, USA.
⁴ Los Angeles County Department of Health Services, Los Angeles, CA, USA.
⁵ Department of Medicine, Division of General Internal Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
⁶ Massachusetts General Physicians Organization, Massachusetts General Hospital, 50 Staniford Street (940-J), Boston, MA, 02114, USA.
⁷ Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

PMID: 27503436
PMCID: PMC5130951
DOI: 10.1007/s11606-016-3813-0

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Randomized Controlled Trial

Targeted Reminder Phone Calls to Patients at High Risk of No-Show for Primary Care Appointment: A Randomized Trial

Sachin J Shah et al. J Gen Intern Med. 2016 Dec.

. 2016 Dec;31(12):1460-1466. doi: 10.1007/s11606-016-3813-0. Epub 2016 Aug 8. Affiliations

¹ Department of Medicine, Division of General Internal Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. sshah@mgh.harvard.edu.
² Massachusetts General Physicians Organization, Massachusetts General Hospital, 50 Staniford Street (940-J), Boston, MA, 02114, USA. sshah@mgh.harvard.edu.
³ Department of Medicine, Lab of Computer Science, Massachusetts General Hospital, Boston, MA, USA.
⁴ Los Angeles County Department of Health Services, Los Angeles, CA, USA.
⁵ Department of Medicine, Division of General Internal Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
⁶ Massachusetts General Physicians Organization, Massachusetts General Hospital, 50 Staniford Street (940-J), Boston, MA, 02114, USA.
⁷ Department of Dermatology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.

PMID: 27503436
PMCID: PMC5130951
DOI: 10.1007/s11606-016-3813-0

Item in Clipboard

Abstract

Background: No-shows, or missed appointments, are a problem for many medical practices. They result in fragmented care and reduce access for all patients.

Objective: To determine whether telephone reminder calls targeted to patients at high risk of no-show can reduce no-show rates.

Design: Single-center randomized controlled trial.

Participants: A total of 2247 primary care patients in a hospital-based primary care clinic at high risk of no-show (>15 % risk) for their appointment in 7 days.

Intervention: Seven days prior to their appointment, intervention arm patients were placed in a calling queue to receive a reminder phone call from a patient service coordinator. Coordinators were trained to engage patients in concrete planning. All patients received an automated phone call (usual care).

Main measures: Primary outcome was no-show rate. Secondary outcomes included arrival rate, cancellation rate, reschedule rate, time to cancellation, and change in revenue.

Key results: The no-show rate in the intervention arm (22.8 %) was significantly lower (absolute risk difference -6.4 %, p < 0.01, 95 % CI [-9.8 to -3.0 %]) than that in the control arm (29.2 %). Arrival, cancellation, and reschedule rates did not differ significantly. In the intervention arm, rescheduling and cancellations occurred further in advance of the appointment (mean difference, 0.35 days; 95 % CI [0.07-0.64]; p = 0.01). Reimbursement did not differ significantly.

Conclusions: A phone call 7 days prior to an appointment led to a significant reduction in no-shows and increased reimbursement among patients at high risk of no-show. The use of targeted interventions may be of interest to practices taking on increased accountability for population health.

Keywords: access to care; applied informatics; behavior change; population health; primary care redesign.

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Figures
Fig. 1

Study design and allocation.

Fig. 1

Study design and allocation.

Fig. 1

Study design and allocation.

Fig. 2

Time to cancellation by study…

Fig. 2

Time to cancellation by study arm.

Fig. 2

Time to cancellation by study arm.