Why do cardiology out-patient appointments fail in Saudi Arabia?

In a retrospective study, 534 appointments for a cardiology clinic were analysed to determine the frequency of no-show and to identify contributory factors. The overall rate of no-show was 30.1%, which is higher than the 18% and 20% reported from other teaching hospitals. Variables with the strongest univariate association with no-show were nationality (Saudi 35%, non-Saudi 22%; p = 0.0015), gender (males 34%, females 25%; p = 0.03), heart failure (present 44%, absent 27.9%; p = 0.005) and valvular heart disease (present 23.4%, absent 32.6%; p = 0.04). Turning to a stepwise logistic regression to predict no-show behaviour, we found that nationality, gender and heart failure were significant, while valvular heart disease was not. We conclude by recommending that physicians and mass media should share in the responsibility of stressing the importance of keeping out-patient department (OPD) appointments to all patients especially those who are more prone to no-show behaviour, namely male nationals. Telephone and mailed reminders have been used successfully to improve attendance at the OPD, and can be evaluated in our community.