Skip to main content
PMC home page
Journal of the Royal Society of Medicine logoLink to Journal of the Royal Society of Medicine
. 1999 Mar;92(3):114–118. doi: 10.1177/014107689909200304

Reducing non-attendance at outpatient clinics.

C A Stone 1, J H Palmer 1, P J Saxby 1, V S Devaraj 1
PMCID: PMC1297099  PMID: 10396253

Abstract

Outpatient non-attendance is a common source of inefficiency in a health service, wasting time and resources and potentially lengthening waiting lists. A prospective audit of plastic surgery outpatient clinics was conducted during the six months from January to June 1997, to determine the clinical and demographic profile of non-attenders. Of 6095 appointments 16% were not kept. Using the demographic information, we changed our follow-up guidelines to reflect risk factors for multiple non-attendances, and a self-referral clinic was introduced to replace routine follow-up for high risk non-attenders. After these changes, a second audit in the same six months of 1998 revealed a non-attendance rate of 11%--i.e. 30% lower than before. Many follow-up appointments are sent inappropriately to patients who do not want further attention. This study, indicating how risk factor analysis can identify a group of patients who are unlikely to attend again after one missed appointment, may be a useful model for the reduction of outpatient non-attendance in other specialties.

Full text

PDF
116

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Andrews R., Morgan J. D., Addy D. P., McNeish A. S. Understanding non-attendance in outpatient paediatric clinics. Arch Dis Child. 1990 Feb;65(2):192–195. doi: 10.1136/adc.65.2.192. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bottomley W. W., Cotterill J. A. An audit of the factors involved in new patient non-attendance in a dermatology out-patient department. Clin Exp Dermatol. 1994 Sep;19(5):399–400. doi: 10.1111/j.1365-2230.1994.tb02691.x. [DOI] [PubMed] [Google Scholar]
  3. Cawley M. E., Stevens F. M. Non-attendance at outpatient clinics at the Regional Hospital, Galway, Ireland. Soc Sci Med. 1987;25(11):1189–1196. doi: 10.1016/0277-9536(87)90365-0. [DOI] [PubMed] [Google Scholar]
  4. Davies P. Why don't patients turn up? Health Soc Serv J. 1984 Jul 26;94(4907):886–887. [PubMed] [Google Scholar]
  5. Dickey W., Morrow J. I. Can outpatient non-attendance be predicted from the referral letter? An audit of default at neurology clinics. J R Soc Med. 1991 Nov;84(11):662–663. doi: 10.1177/014107689108401112. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Frankel S., Farrow A., West R. Non-attendance or non-invitation? A case-control study of failed outpatient appointments. BMJ. 1989 May 20;298(6684):1343–1345. doi: 10.1136/bmj.298.6684.1343. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Grover S., Gagnon G., Flegel K. M., Hoey J. R. Improving appointment-keeping by patients new to a hospital medical clinic with telephone or mailed reminders. Can Med Assoc J. 1983 Nov 15;129(10):1101–1103. [PMC free article] [PubMed] [Google Scholar]
  8. Herrick J., Gilhooly M. L., Geddes D. A. Non-attendance at periodontal clinics: forgetting and administrative failure. J Dent. 1994 Oct;22(5):307–309. doi: 10.1016/0300-5712(94)90068-x. [DOI] [PubMed] [Google Scholar]
  9. King A., David D., Jones H. S., O'Brien C. Factors affecting non-attendance in an ophthalmic outpatient department. J R Soc Med. 1995 Feb;88(2):88–90. [PMC free article] [PubMed] [Google Scholar]
  10. Leese A. M., Wilson J. A., Murray J. A. A survey of the non-attendance rate at the ENT clinic of a district general hospital. Clin Otolaryngol Allied Sci. 1986 Feb;11(1):37–40. doi: 10.1111/j.1365-2273.1986.tb00104.x. [DOI] [PubMed] [Google Scholar]
  11. Lloyd M., Bradford C., Webb S. Non-attendance at outpatient clinics: is it related to the referral process? Fam Pract. 1993 Jun;10(2):111–117. doi: 10.1093/fampra/10.2.111. [DOI] [PubMed] [Google Scholar]
  12. Mason C. Non-attendance at out-patient clinics: a case study. J Adv Nurs. 1992 May;17(5):554–560. doi: 10.1111/j.1365-2648.1992.tb02832.x. [DOI] [PubMed] [Google Scholar]
  13. McGlade K. J., Bradley T., Murphy G. J., Lundy G. P. Referrals to hospital by general practitioners: a study of compliance and communication. BMJ. 1988 Nov 12;297(6658):1246–1248. doi: 10.1136/bmj.297.6658.1246. [DOI] [PMC free article] [PubMed] [Google Scholar]
  15. Partridge J. W. Consultation time, workload, and problems for audit in outpatient clinics. Arch Dis Child. 1992 Feb;67(2):206–210. doi: 10.1136/adc.67.2.206. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Potamitis T., Chell P. B., Jones H. S., Murray P. I. Non-attendance at ophthalmology outpatient clinics. J R Soc Med. 1994 Oct;87(10):591–593. doi: 10.1177/014107689408701007. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. Ross J. D., McIver A., Blakely A., Dalrymple J., Peacock W., Wallis C. Why do patients default from follow-up at a genitourinary clinic?: a multivariate analysis. Genitourin Med. 1995 Dec;71(6):393–395. doi: 10.1136/sti.71.6.393. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. Turner A. G., Cooke H. Are patients' attitudes the cause of long waiting lists? Br J Clin Pract. 1991 Summer;45(2):97–98. [PubMed] [Google Scholar]
  19. Verbov J. Why 100 patients failed to keep an outpatient appointment-audit in a dermatology department. J R Soc Med. 1992 May;85(5):277–278. [PMC free article] [PubMed] [Google Scholar]

Articles from Journal of the Royal Society of Medicine are provided here courtesy of Royal Society of Medicine Press

RESOURCES