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Patient Portal Access and Missed Medical Appointments: A Case-Control Study.

Shira Goldstein¹, Kaylee Buuck², Hannah Thompson²

¹Department of Family and Community Medicine, UTHealth McGovern Medical School, Houston, TX, USA.

Journal of Patient Experience

|January 22, 2026

Summary

Patient portal access significantly reduces missed primary care appointments. Digital tools like patient portals can improve patient visit adherence and reduce healthcare costs.

Keywords:

case-control missed appointments patient portal primary care

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Area of Science:

Health Services Research
Digital Health
Primary Care Medicine

Background:

Missed primary care appointments (no-shows) negatively impact timely access to care and increase healthcare expenses.
The 21st Century Cures Act promotes patient portal expansion, potentially altering patient-provider engagement.
Digital tools are increasingly integrated into healthcare delivery.

Purpose of the Study:

To investigate the association between patient portal access and missed appointments in primary care.
To identify factors associated with no-shows in an academic family medicine setting.

Main Methods:

A case-control study was conducted using electronic medical records from April to May 2023.
Cases were patients aged 18+ who missed appointments; two controls (attending patients) were randomly selected per case.
Logistic regression analyzed the link between patient portal access and no-shows, adjusting for covariates.

Main Results:

Patients with missed appointments were less likely to have patient portal access (OR: 0.43; 95% CI: 0.30-0.59).
No-shows were more common among non-Hispanic Black, Hispanic patients, and those with public or no insurance.
Hypertension and osteoarthritis were associated with fewer no-shows.

Conclusions:

Patient portal access is linked to a reduced likelihood of missed primary care appointments.
Digital engagement tools may enhance adherence to scheduled visits.
Interventions promoting patient portal use could mitigate no-show rates.