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Missed appointments and Medicaid managed care
B A Majeroni1, T Cowan, J Osborne
1State University of New York at Buffalo, USA. bmajeron@ubmedb.buffalo.edu
Archives of Family Medicine
|October 1, 1996
Summary
Patients in managed care programs, particularly Medicaid, missed more appointments. Younger adults, Black patients, and those scheduling more visits were also more likely to miss appointments, indicating a need for targeted interventions.
Area of Science:
- Health Services Research
- Primary Care Medicine
- Health Disparities
Background:
- Appointment attendance is crucial for patient care continuity and healthcare system efficiency.
- Understanding patient demographics and insurance status can help identify those at higher risk of missed appointments.
- Targeted interventions are needed to reduce missed appointments and improve healthcare access.
Purpose of the Study:
- To compare demographic characteristics of patients who miss appointments versus those who do not.
- To identify specific patient subgroups that would benefit from interventions aimed at improving appointment attendance.
Main Methods:
- Retrospective cohort study analyzing 18 months of data from an urban primary care practice.
- A random sample of 477 established patients (seen at least twice) was analyzed.
- Data included missed/kept visits, insurance, demographics (age, sex, race, ZIP code), and diagnoses.
Main Results:
- 48% of established patients missed at least one appointment.
- Patients in managed care (private and Medicaid) missed more appointments than those not in managed care (P < .001).
- Higher missed appointment rates were observed in younger adults (19-35 years), Black patients, Medicaid managed care patients, and those scheduling more visits (all P < .001).
Conclusions:
- Managed care patients, especially those in Medicaid managed care programs, exhibit higher rates of missed appointments.
- Medicaid managed care patients also scheduled more visits, contributing to a higher overall missed appointment rate.
- Demographic factors like age and race, along with insurance type, are significant predictors of missed appointments, highlighting areas for intervention.