Factors Affecting Missed Appointments in a Pediatric Urology Outpatient Clinic

Missed appointments can have an adverse effect on patient care and clinic efficiency. We hypothesized that increased fuel costs and travel distance, nonchronic health conditions, different seasons, government subsidized insurance and older age would result in higher no-show rates in our pediatric urology outpatient clinic.

We retrospectively reviewed 1,315 consecutive scheduled visits from 514 patients during 2008 to 2009. Patient arrival status was recorded, as well as demographic data, chief complaint, type of visit, the month and day of the week of the scheduled appointment, and distance traveled. The average gas price at the time of the appointment was also recorded. A logistic regression model analysis fitted by the method of generalized estimating equations was used to determine correlations of the outcome with a single independent variable. Factors that had an association with p <0.10 were then included in a multifactor logistic model fitted by the generalized estimating equation method.

The overall rate of no-shows was 39%. On multifactor analysis the variables associated with higher rates of missed appointments included increasing patient age (p <0.01), having federal insurance (p=0.04), being uninsured (p <0.01), nonchronic conditions (p=0.03), return visits (p <0.01), Friday appointments (p=0.04) and summer appointments (p=0.05).

No-show rates varied by multiple factors such as age, insurance status, chief complaint and new or return status. Contrary to conventional wisdom, distance traveled and gas prices were not associated with missed appointments. This pilot information may present an opportunity to improve clinic efficiency and improve patient access.