No-show appointments result in wasted resources for health institutions and patients who need services. This study aimed to determine the reasons for no-show appointments and patients’ opinions on potential interventions to prevent them. This study was conducted at a university hospital in Türkiye and included 795 patients. The sample size was first distributed according to the weights of internal and surgical outpatient clinics, and patients from these clinics were selected using convenience sampling. A questionnaire was used to determine why patients did not attend hospital appointments in the previous month and their opinions about potential measures to minimise non-attendance. Possible reasons for no-show appointments, such as ‘forgetting’, ‘being somewhere else’ and ‘taking care of family’, came to the fore. Among the possible preventive measures, 24-h reminders, timely maintenance and repair of medical devices, notifying the patient of appointment cancellations/changes, advance planning of doctors’ meetings, easy access to the appointment cancellation system and informing patients about appointment cancellation methods were considered effective. However, measures such as temporarily denying appointments to patients who do not attend them and fees for missed appointments were observed to be less effective. In all, 41% of the patients requested reminders of their appointments via SMS and mobile phone. Determining patients’ opinions about the reasons for no-show appointments and potential preventive measures will contribute to a better understanding of the problem and the design of effective interventions.
AggarwalA., DaviesJ., & SullivanR. (2016). “Nudge” and the epidemic of missed appointments: Can behavioural policies provide a solution for missed appointments in the health service?Journal of Health, Organisation and Management, 30(4), 558–564. https://doi.org/10.1108/JHOM-04-2015-0061
2.
AlhamadZ. (2013). Reasons for missing appointments in general clinics of primary health care center in Riyadh Military Hospital, Saudi Arabia. International Journal of Medical Science and Public Health, 2(2), 258–267. https://doi.org/10.5455/ijmsph.2013.2.256-265
3.
BechM. (2005). The economics of non-attendance and the expected effect of charging a fine on non-attendees. Health Policy, 74, 181–191. https://doi.org/10.1016/j.healthpol.2005.01.001
4.
BhatiaR., EshaC. V., & PandaA. (2018). Pediatric dental appointments no-show: Rates and reasons. International Journal of Clinical Pediatric Dentistry, 11(3), 171–176. https://doi.org/10.5005/jp-journals-10005-1506
5.
ChenZ. W., FangL. Z., ChenL. Y., & DaiH. L. (2008). Comparison of an SMS text messaging and phone reminder to improve attendance at a health promotion center: A randomized controlled trial. Journal of Zhejiang University: Science B, 9(1), 34–38. https://doi.org/10.1631/jzus.B071464
6.
ClouseK. M., WilliamsK. A., & HarmonJ. M. (2017). Improving the no-show rate of new patients in outpatient psychiatric practice: An advance practice nurse-initiated telephone engagement protocol quality improvement project. Perspectives in Psychiatric Care, 53(2), 127–134. https://doi.org/10.1111/ppc.12146
7.
DaggyJ., LawleyM., WillisD., ThayerD., SuelzerC., DelaurentisP. C., TurkcanA., ChakrabortyS., & SandsL. (2010). Using no-show modeling to improve clinic performance. Health Informatics Journal, 16(4), 246–259. https://doi.org/10.1177/1460458210380521
8.
DuMontierC., RindfleischK., PruszynskiJ., & FreyJ. J. (2013). A multi-method intervention to reduce no-shows in an urban residency clinic. Family Medicine, 45(9), 634–641.
9.
FousheeE. R. (2020). Quantitative & retrospective study of the economic impact of no-shows in a hospital-based outpatient psychiatric clinic. Northcentral University.
10.
FrostL., JenkinsL. S., & EmminkB. (2017). Improving access to health care in a rural regional hospital in South Africa: Why do patients miss their appointments?African Journal of Primary Health Care and Family Medicine, 9(1). https://doi.org/10.4102/phcfm.v9i1.1255
11.
GebhartT. (2017). No-show management in primary care: A quality improvement project. Oregon Health and Science University. https://doi.org/10.6083/m4f47npq
12.
GierJ. (2017, June14). Missed appointments cost the U.S. healthcare system $150B each year. Healthcare Innovation. https://www.hcinnovationgroup.com/clinical-it/article/13008175/missed-appointments-cost-the-us-healthcare-system-150b-each-year
13.
Gurol-UrganciI., de JonghT., Vodopivec-JamsekV., AtunR., & CarJ. (2013). Mobile phone messaging reminders for attendance at healthcare appointments. Cochrane Database of Systematic Reviews, 2013(12). https://doi.org/10.1002/14651858.CD007458.pub3
14.
GuseC. E., RichardsonL., CarleM., & SchmidtK. (2003). The effect of exit-interview patient education on no-show rates at a family practice residency clinic. Journal of the American Board of Family Practice, 16(5), 399–404. https://doi.org/10.3122/jabfm.16.5.399
15.
HamiltonW., LuthraM., SmithT., & EvansP. (2002). Non-attendance in general practice: A questionnaire survey. Primary Health Care Research and Development, 3, 226–230. https://doi.org/10.1191/1463423602pc106oa
16.
HonK. L. E., LeungT. F., WongY., MaK. C., & FokT. F. (2005). Reasons for new referral non-attendance at a pediatric dermatology center: A telephone survey. Journal of Dermatological Treatment, 16(2), 113–116. https://doi.org/10.1080/09546630510027877
17.
Hussain-GamblesM., NealR. D., DempseyO., LawlorD. A., & HodgsonJ. (2004). Missed appointments in primary care: Questionnaire and focus group study of health professionals. British Journal of General Practice, 54, 108–113.
18.
Kaplan-LewisE., & Percac-LimaS. (2013). No-show to primary care appointments: Why patients do not come. Journal of Primary Care and Community Health, 4(4), 251–255. https://doi.org/10.1177/2150131913498513
19.
KarterA. J., ParkerM. M., MoffetH. H., AhmedA. T., FerraraA., LiuJ. Y., & SelbyJ. V. (2004). Missed appointments and poor glycemic control: An opportunity to identify high-risk diabetic patients. Medical Care, 42(2), 110–115. https://doi.org/10.1097/01.mlr.0000109023.64650.73
20.
KheirkhahP., FengQ., TravisL. M., Tavakoli-TabasiS., & SharafkhanehA. (2016). Prevalence, predictors and economic consequences of no-shows. BMC Health Services Research, 16(13), 1–6. https://doi.org/10.1186/s12913-015-1243-z
21.
KimS., & GiachettiR. E. (2006). Model for healthcare providers to improve profits. IEEE Transactions on Systems, Man, and Cybernetics—Part A: Systems and Humans, 36(6), 1211–1219.
22.
LesacaT. (1995). Assessing the influence of a no-show fee on patient compliance at a CMHC. Administration and Policy in Mental Health, 22(6), 629–631.
23.
MäntyjärviM. (1994). No-show patients in an ophthalmological out-patient department. Acta Ophthalmologica, 72(3), 284–289.
24.
MarbouhD., KhaleelI., ShanqitiK. Al, TamimiM. Al, SimseklerM. C. E., EllahhamS., AlibazogluD., & AlibazogluH. (2020). Evaluating the impact of patient no-shows on service quality. Risk Management and Healthcare Policy, 13, 509–517. https://doi.org/10.2147/RMHP.S232114
25.
MieloszykR. J., RosenbaumJ. I., HallC. S., RaghavanU. N., & BhargavaP. (2018). The financial burden of missed appointments: Uncaptured revenue due to outpatient no-shows in radiology. Current Problems in Diagnostic Radiology, 47, 285–286. https://doi.org/10.1067/j.cpradiol.2018.06.001
26.
MohamedB. A., & Al-DoghaitherA. H. (2002). Missed appointments at public hospitals in Riyadh, Saudi Arabia. Saudi Medical Journal, 23(4), 388–392.
27.
MooreC. G., Wilson-WitherspoonP., & ProbstJ. C. (2001). Time and money: Effects of no-shows at a family practice residency clinic. Family Medicine, 33(7), 522–527.
28.
MurdockA., RodgersC., LindsayH., & ThamT. C. K. (2002). Why do patients not keep their appointments? Prospective study in a gastroenterology outpatient clinic. Journal of the Royal Society of Medicine, 95, 284–286. https://doi.org/10.1258/jrsm.95.6.284
MurrayM., & BerwickD. M. (2003). Advanced access: Reducing waiting and delays in primary care. Journal of the American Medical Association, 289(8), 1035–1040. https://doi.org/10.1001/jama.289.8.1035
31.
MurrayM., & TantauC. (2000). Same-day appointments: Exploding the access paradigm. Family Practice Management, 7(8), 45–50.
32.
NealR. D., Hussain-GamblesM., AllgarV. L., LawlorD. A., & DempseyO. (2005). Reasons for and consequences of missed appointments in general practice in the UK: Questionnaire survey and prospective review of medical records. BMC Family Practice, 6(47). https://doi.org/10.1186/1471-2296-6-47
33.
NguyenD. L., & DejesusR. S. (2010). Increased frequency of no-shows in residents’ primary care clinic is associated with more visits to the emergency department. Journal of Primary Care & Community Health, 1(1), 8–11. https://doi.org/10.1177/2150131909359930
34.
Renee Miller-MateroL., ColemanJ. P., AragonR., & YanezJ. (2018). Identifying predictors of emergency room utilization in primary care. Journal of General Internal Medicine, 33(10), 1629–1630. https://doi.org/10.1007/s11606-018-4529-0
35.
SamuelsR. C., WardV. L., MelvinP., Macht-GreenbergM., WenrenL. M., YiJ., MasseyG., & CoxJ. E. (2015). Missed appointments: Factors contributing to high no-show rates in an urban pediatrics primary care clinic. Clinical Pediatrics, 54(10), 976–982. https://doi.org/10.1177/0009922815570613
36.
SatianiB., MillerS., & PatelD. (2009). No-show rates in the vascular laboratory: Analysis and possible solutions. Journal of Vascular and Interventional Radiology, 20(1), 87–91. https://doi.org/10.1016/j.jvir.2008.09.027
37.
SkaretE., RaadalM., KvaleG., & BergE. (2000). Factors related to missed and cancelled dental appointments among adolescents in Norway. European Journal of Oral Sciences, 108(3), 175–183. https://doi.org/10.1034/j.1600-0722.2000.108003175.x
38.
VijayanM. (2014). No shows: Effectiveness of termination policy and review of best practices[Master of Public Health Project, Wright State University]. CORE Scholar. https://corescholar.libraries.wright.edu/mph/118/
ZailinawatiA. H., NgC. J., & Nik-SherinaH. (2006). Why do patients with chronic illnesses fail to keep their appointments? A telephone interview. Asia-Pacific Journal of Public Health, 18(1), 10–15.
