Missed Appointments in a Breast Clinic: Patient-Related Factors

Background: Missed appointments are problematic because they occupy an appointment that could have been used by another patient and represent lost resources for the hospital system. The objective of this study was to determine patient-related factors associated with missed appointments.

Methods: Totally, 1,624 patients were seen from January 14, 2010 to January 16, 2012. Sociodemographic variables were collected including health literacy assessment, electronic medical record system-collected scheduled appointments and missed appointments for each patient. Patients were also asked for their preferred method of contact.

Results: From January 1, 2009 to January 16, 2012 the 1,624 patients had 21,648 scheduled appointments in the hospital system. Overall 3,633 (16.8%) of the appointments were missed. Insurance status, income, education and primary language were not significant predictors for missed appointments. Limited health literacy was associated with increased rate of missed appointments (adequate health literacy 13.4% versus limited health literacy 17.2%, P = 0.0009). Current smokers had higher rates of missed appointments than nonsmokers (18.5% versus 16.1%, P = 0.025). Patients who underwent screening mammography were also less likely to miss appointments (odds ratio = 0.78, P < 0.0001). The preferred method of contact was via mobile phone; however, this was only 42%.

Conclusions: Patients with limited health literacy and current smokers had higher rates of missed appointments. In addition, patients who were compliant with screening mammography were also more likely to be compliant with appointments. Appointment reminders should be kept simple to accommodate the rapidly growing population with limited health literacy.