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Cancelled Primary Care Appointments: A Prospective Cohort Study of Diabetic Patients

  • Systems-Level Quality Improvement
  • Published:
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Abstract

Patients scheduled for primary care appointments often cancel or no show. For diabetic patients, nonattendance can affect continuity of care and result in higher emergency department (ED) and hospital use. Nonattendance also impacts appointment scheduling, patient access, and clinic work load. While no show has received significant attention, little research has addressed the prevalence and impact of appointment cancellation. Data on 46,710 appointments for 7586 adult diabetic patients was used to conduct a prospective cohort study examining primary care appointment behavior. The independent variable was the status of the INDEX appointment, which was attended, cancelled, or no showed. Dependent variables included the dates of (1) the last attended appointment, (2) scheduling the NEXT appointment, (3) the next attended follow-up appointment, and (4) ED visits and hospitalizations within six months of the INDEX. Cancellation was more prevalent than no show (17.7% vs 12.2%). Of those who cancelled and scheduled a next appointment, 28.8% experienced over 30 days delay between the INDEX and NEXT appointment dates, and 59.9% delayed rescheduling until on or after the cancelled appointment date. Delay in rescheduling was associated with an 18.6% increase in days between attended appointments and a 26.0% increase in ED visits. For diabetic patients, cancellation with late rescheduling is a prevalent and unhealthy behavior. Although more work is necessary to address the health, intervention, and cost issues, this work suggests that cancellation, like no show, may be problematic for many clinics and patients.

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Author information

Authors and Affiliations

  1. Purdue University, West Lafayette, IN, USA

    Sara McComb, Zhiyi Tian, Lingsong Zhang & Shree Frazier

  2. Virginia Tech, Blacksburg, VA, USA

    Laura Sands

  3. Fire Department of the City of New York, New York, NY, USA

    Ayten Turkcan

  4. Texas A&M University, College Station, TX, USA

    Mark Lawley

Authors
  1. Sara McComb
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  2. Zhiyi Tian
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  3. Laura Sands
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  4. Ayten Turkcan
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  5. Lingsong Zhang
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  6. Shree Frazier
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  7. Mark Lawley
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Correspondence to Sara McComb.

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All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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No informed consent was required. Analyses were performed using a Limited Data Set.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

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McComb, S., Tian, Z., Sands, L. et al. Cancelled Primary Care Appointments: A Prospective Cohort Study of Diabetic Patients. J Med Syst 41, 53 (2017). https://doi.org/10.1007/s10916-017-0700-0

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  • DOI: https://doi.org/10.1007/s10916-017-0700-0

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