An appointment-keeping improvement package for outpatient pediatrics: systematic replication and component analysis

Area of Science:

• Pediatric healthcare management
• Healthcare access and utilization
• Patient adherence studies

Background:

• Missed child healthcare appointments represent a significant pediatric problem.
• Previous interventions like parking passes and mailed/phone reminders improved adherence for initial and patient-scheduled visits.
• The effectiveness of these interventions for clinic-scheduled follow-up appointments required further investigation.

Purpose of the Study:

• To evaluate the impact of combining effort reduction and reminder interventions on keeping clinic-scheduled follow-up pediatric appointments.
• To determine if these interventions could decrease the rate of missed appointments.
• To identify factors influencing appointment keeping for follow-up care.

Main Methods:

• A posttest-only group design was employed.
• Interventions included combinations of mailed reminders and reduced patient effort (e.g., parking pass).
• Log linear analyses were used to examine the influence of lag time between scheduling and appointment date.

Main Results:

• All intervention combinations significantly increased appointment cancellations.
• No intervention combination significantly increased the number of appointments kept.
• No intervention combination significantly decreased the number of appointments not kept.
• Log linear analyses indicated that the time lag between scheduling and the appointment date was a significant factor in appointment keeping.

Conclusions:

• For pediatric clinics aiming to increase appointment cancellations, mailed reminders and effort reduction strategies are effective.
• To improve appointment keeping rates for follow-up visits, interventions focusing on reducing the time lag between scheduling and the appointment are likely necessary.
• Further research into tailored interventions for follow-up appointment adherence is warranted.