Evaluating the causes of missed care opportunities in a pediatric subspecialty
Embargo Date
2028-02-25
OA Version
Citation
Abstract
BACKGROUND: Missed care opportunities (MCOs), referred to as no-shows, occur when a patient fails to attend a scheduled appointment or cancels it within 24 hours of the scheduled time. MCOs disrupt the healthcare system by decreasing hospital revenue, physician efficiency, and patient health outcomes. MCOs cause a break in the continuity of care, can delay the diagnosis of acute or chronic diseases, or result in a worse clinical outcome. Previous MCO studies have relied on limited retrospective data to draw conclusions about the occurrence of MCO. In this study, we employ a prospective approach to gain a more complete understanding of the causes of MCOs in a population of subspecialty patients.
SPECIFIC AIMS: This study aims to identify the reasons that contributed to pediatric gastroenterology patients missing their scheduled clinic appointments. A prospective approach was employed to collect information about patients, informing subsequent efforts to develop targeted interventions aimed at reducing the MCO rate in this clinic.
METHODS: We conducted an over-the-phone survey to gather information from parents or guardians of patients regarding what contributed to their missing a recent appointment. The data collected from the survey provided insights into the impact of factors, including language preferences, patient portal use, and reminder status, on MCO rates. We also gained information about factors such as race and previous history of no-shows from the electronic medical record (Epic).
RESULTS: The data collected in this study identified several reasons contributing to why patients miss their appointments. We also identified important information about the type of missed appointments. Patients scheduled to complete follow-up appointments have had the highest MCO rate. Patients reported that the appointment reminders they received were sent by text, and they preferred receiving future reminders through text messages.
CONCLUSION: Our findings provided more detailed insight into why patients followed in the pediatric gastroenterology clinic missed scheduled clinic appointments. By employing this approach in our study, we gained a deeper understanding of the direct circumstances that lead to patients missing their appointments. We plan to use this information to create targeted interventions that are likely to be more effective in lowering the MCO rate by addressing specific patient populations and evidence-based circumstances.
Description
2025
License
Attribution-NonCommercial-NoDerivatives 4.0 International