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Randomized Controlled Trial
. 2016 Dec;31(12):1460-1466.
doi: 10.1007/s11606-016-3813-0. Epub 2016 Aug 8.

Targeted Reminder Phone Calls to Patients at High Risk of No-Show for Primary Care Appointment: A Randomized Trial

Sachin J Shah  1   2 , Patrick Cronin  3 , Clemens S Hong  4 , Andrew S Hwang  5 , Jeffrey M Ashburner  5 , Benjamin I Bearnot  5 , Calvin A Richardson  6 , Blair W Fosburgh  5 , Alexandra B Kimball  6   7
Affiliations
Randomized Controlled Trial

Targeted Reminder Phone Calls to Patients at High Risk of No-Show for Primary Care Appointment: A Randomized Trial

Sachin J Shah et al. J Gen Intern Med. 2016 Dec.

Abstract

Background: No-shows, or missed appointments, are a problem for many medical practices. They result in fragmented care and reduce access for all patients.

Objective: To determine whether telephone reminder calls targeted to patients at high risk of no-show can reduce no-show rates.

Design: Single-center randomized controlled trial.

Participants: A total of 2247 primary care patients in a hospital-based primary care clinic at high risk of no-show (>15 % risk) for their appointment in 7 days.

Intervention: Seven days prior to their appointment, intervention arm patients were placed in a calling queue to receive a reminder phone call from a patient service coordinator. Coordinators were trained to engage patients in concrete planning. All patients received an automated phone call (usual care).

Main measures: Primary outcome was no-show rate. Secondary outcomes included arrival rate, cancellation rate, reschedule rate, time to cancellation, and change in revenue.

Key results: The no-show rate in the intervention arm (22.8 %) was significantly lower (absolute risk difference -6.4 %, p < 0.01, 95 % CI [-9.8 to -3.0 %]) than that in the control arm (29.2 %). Arrival, cancellation, and reschedule rates did not differ significantly. In the intervention arm, rescheduling and cancellations occurred further in advance of the appointment (mean difference, 0.35 days; 95 % CI [0.07-0.64]; p = 0.01). Reimbursement did not differ significantly.

Conclusions: A phone call 7 days prior to an appointment led to a significant reduction in no-shows and increased reimbursement among patients at high risk of no-show. The use of targeted interventions may be of interest to practices taking on increased accountability for population health.

Keywords: access to care; applied informatics; behavior change; population health; primary care redesign.

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Figures

Fig. 1
Fig. 1
Study design and allocation.
Fig. 2
Fig. 2
Time to cancellation by study arm.
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