Weekday affects attendance rate for medical appointments: large-scale data analysis and implications

Area of Science:

• Healthcare Management
• Health Services Research
• Public Health Policy

Background:

• Missed healthcare appointments incur substantial financial costs, necessitating strategies to improve patient attendance.
• Factors influencing missed appointments often lie outside healthcare providers' control, such as patient demographics and transport.
• Appointment scheduling represents an administratively controllable factor with potential to influence attendance rates.

Purpose of the Study:

• To investigate whether modifying appointment scheduling policies can reduce the rate of Did Not Attend (DNA) events.
• To analyze the relationship between the day of the week and appointment attendance across different healthcare settings.

Main Methods:

• Study 1: Retrospective analysis of 4,538,294 outpatient hospital appointments in Scotland (2008-2010).
• Study 2: Analysis of 10,895 appointments at a single general practitioner clinic in Glasgow.
• Statistical comparison of DNA rates across different days of the week, considering patient demographics and setting.

Main Results:

• DNA rates were consistently higher on Mondays and decreased monotonically towards Fridays in both hospital and GP settings.
• A significant weekly decline in DNA rates was observed (Scotland: 11.8% reduction; Glasgow: 32.3% reduction).
• This pattern was consistent across age and gender groups, with a steeper decline noted in younger patients.

Conclusions:

• Appointment timing significantly impacts attendance, with early-week appointments being more frequently missed.
• Healthcare providers can reduce DNA rates by strategically scheduling more appointments on days with historically higher attendance, such as Fridays.
• Implementing preferential scheduling on high-attendance days offers a practical administrative solution to mitigate the financial burden of missed appointments.