Longer appointment duration reduces future missed appointments in safety-net clinics.

Abstract

Objective: To determine whether longer prior appointment durations are associated with reduced missed appointment rates.

Study design: Retrospective cohort study at a large Texas federally qualified health center network.

Methods: The dependent variable was missed appointments, and the primary independent variable was prior appointment duration. Other independent variables included sociodemographic (age, sex, race/ethnicity, insurance status), geographic (distance to the clinic, residence in a medically underserved area [MUA]), and clinical (visit history, visit type, visit dates, days between visits) factors. We used mixed-effects logistic regression to examine the relationship between prior appointment duration and missed appointments.

Results: The study sample included 28,090 unique patients who had 56,180 appointments. The regression model demonstrated that longer prior appointment duration was associated with a lower likelihood of a missed appointment (OR, 0.90; 95% CI, 0.88-0.92). Being Hispanic or non-Hispanic Black (Hispanic: OR, 1.08; 95% CI, 1.03-1.15; Black: OR, 1.49; 95% CI, 1.38-1.61), lacking insurance (OR, 1.47; 95% CI, 1.38-1.57), and living 40 or more miles from the clinic (OR, 1.21; 95% CI, 1.08-1.36) were associated with higher odds of missing appointments. In contrast, living in an MUA (OR, 0.92; 95% CI, 0.82-0.96), having 3 or more previous visits (3-4 visits: OR, 0.87; 95% CI, 0.82-0.93), having more days between visits (91-180 days between visits: OR, 0.54; 95% CI, 0.50-0.59), and scheduling visits with physicians (OR, 0.90; 95% CI, 0.86-0.95) were associated with lower odds of missing appointments.

Conclusions: Duration of past appointments is inversely correlated with future missed appointment rates. Efforts to lengthen appointment times may have important effects on quality and health outcomes.