Failure to keep appointments at a community health centre. Analysis of causes

The scheduled appointment system in primary care clinics became popular recently in Israel. Failed appointments created a problem for the doctors, patients and the clinic in Netivot. During 11 months, 2.317 appointments were surveyed. The survey showed 36% of failed appointments, with a decrease to 28% one year later. Rates of failed appointments were 38% for the paediatric population, 35% for adults, and 34% for pensioners. Market days and holidays predisposed to more failed appointments, representing community customs. The presence of a chronic disease that needed follow up ensured a higher rate of attendance (76%), especially among the paediatric population (92% attendance rate). By contrast, a geriatric patient with an acute disease had difficulty attending the clinic (only 16% attending). 512 people (35% of the population) were responsible for the 827 failed appointments, and among them only 12% of the population accounted for 59% of the failed appointments. These findings have important implications in the planning of an appointment system in an urban health centre, and they strengthen the assumption that a small number of patients cause a large number of failed appointments.