[Causes for failure of the medical appointment program in a family medicine clinic]

The objective of this study was to identify, for both patients and health services, the probable causes for non-attendance at medical appointments in a family medicine clinic located in Mexico City. The three top reasons of visit, type 2 diabetes, hypertension and antenatal care were analyzed. Four hundred and thirty-nine patients who missed their appointment during May 2004 answered an interview. Patient's variables were age, gender, schooling, employment status, workday, employer support to attend to the appointment, physical conditions, family support, affordability of the travel expenses to attend to the clinic, place of residence, forgetting the appointment and hospitalization. Health services variables were conflict between the dates of the appointment with the family doctor and with the laboratory, mistakes in the agenda, re-scheduling or cancellation of the appointment, entitlement to receive medical care, absence of the family doctor, and patient's decision to leave the clinic before the appointment. Data were analyzed by using descriptive statistics. 45.8% of patients forgot their appointment and 44% had administrative problems that impaired their receive medical care; 76.4% of pregnant women had administrative problems as well. Addressing these two possible causes is essential to the success of the medical appointment program.