Missed Care Appointments: Survey Results From a Safety-Net Breast Imaging Practice

Missed appointments in breast imaging delay care and may negatively affect outcomes. This study aimed to identify factors associated with missed breast imaging appointments and understand patient-reported reasons for no-shows to inform targeted interventions in a medically underserved population.

This quality improvement project, designated as non-regulated research, surveyed 165 patients who had previously missed a breast imaging appointment and were rescheduled. Participants completed a questionnaire in-person or by telephone regarding reasons for missing appointments and suggestions to improve attendance. Demographic information was collected. Associations between sociodemographics and reasons for missed appointments and reminder types were analyzed.

Of 260 patients identified for the survey, 165 (63%) responded. The most frequent reasons for missed appointments were lack of awareness or forgotten appointments (35%, 57/165), financial hardship (19%, 31/165), and transportation issues (20%, 33/165). Suggested improvements included enhanced appointment reminders (29%, 48/165), funding or insurance assistance (12%, 20/165), and transportation support (8%, 13/165). Most patients selected only one type of reminder (63%, 104/165), with text messaging the most selected for those choosing a single reminder type (38%, 39/104). Differences in responses for missed appointments were associated with different income levels, while no association of sociodemographics with preferred reminder type was seen.

Reducing missed breast imaging appointments is essential to improving access to timely care, particularly in underserved populations. Optimizing appointment reminders, especially through patient-selected reminder types and addressing financial and transportation barriers may improve adherence and promote equitable access to breast imaging services.