This paper describes a number of steps we have initiated to study our chronic waiting list problems. We describe a program involving monthly data collection which has enabled us to document the effectiveness of some strategies and predictive variables. During 1989 the data were supplemented with information collected by a questionnaire mailed to every other referral. We found that an initial response to the questionnaire was a powerful predictor of successfully kept first appointments six to 12 months later. The significance of these differences, the impact of our tracking procedures and the issues and causes, along with some strategies, are discussed.
References
1.
el-GuebalyN, PapineauD.Economic constraints and quality assurance in mental health services: sensitive indicators. Can J Psychiatry1984; 29(2): 115–120.
2.
GersonLW, McCordG, WigginSL. A strategy to increase appointment keeping in a pediatric clinic. J Community Health1986; II: 111–121.
AndersonFP, RoweDS, DeanVC, An approach to the problem of noncompliance in a pediatric outpatient clinic. J Dis Child1971; 122: 142–143.
5.
CraigJT, HuffineCL, BrooksM.Completion of referral to psychiatric services by inner city residents. Arch Gen Psychiatry1974; 31: 353–357.
6.
BrookerBH, JoyntM, FroeseAP. Impact of removing the waiting list upon clinic intakes. Can J Psychiatry1986; 31(6): 521–525.
7.
LefebvreA, WeissE, CohenN, Intake followup of “no service” cases. Can J Psychiatry1981; 26(3): 183–185.
8.
LefebvreA, SommerhauerJ, CohenN, Where did all the “no-shows” go? Can J Psychiatry1983; 28(5): 387–390.
9.
PaolilliJGP, MooreTW. Appointment compliance behavior of community mental health patients: discriminant analysis. Community Mental Health J1984; 20: 103–108.
10.
DubinskyM.Predictors of appointment non-compliance in community mental health patients. Community Mental Health J1986; 22: 142–146.
11.
GoldmanL, FriedinR, CookEF, A multivarient approach to. the prediction of no-show behavior in a primary care center. Arch Intern Med1982; 142: 563–567.
CooperNA, LynchMA. Lost to follow up: a study of nonattendance at a general paediatric outpatient clinic. Arch Dis Child1979; 55: 765–769.
14.
McGladeKJ, BradleyT, MurphyGJJ, Referrals to hospital by general practitioners: a study of compliance and communication. Br Med J1988; 297: 1246–1248.
15.
FlaskerudJH. The effects of culture-compatible intervention on the utilization of mental health services by minority clients. Community Mental Health J1986; 22: 127–141.
16.
HurtadoAV, GreenllickMR, ColomboTJ. Detriments of medical care utilization: failure to keep appointments. Med Care1973; 11: 189–198.
CampbellB, StaleyD, MatasM.Who misses appointments? An empirical analysis. Can J Psychiatry1991; 36(3): 223–225.
19.
BarronWM. Failed appointments. Who misses them, why they are missed, and what can be done. Primary Care1980; 7: 563–574.
20.
Gunter-HuntG, FergusonKJ, BoleGG. Appointment-keeping behavior and patient satisfaction: implications for health professionals. Patient Counselling and Health Education1982; 3: 156–160.
21.
BudmanSH, DembyAB, FeldsteinML. A controlled study of the impact of mental health treatment on medical care utilization. Med Care1984; 22: 216–222.
22.
MorseDL, CoulterMP, NazarianLF, Waning effectiveness of mailed reminders on reducing broken appointments. Pediatrics1981; 68: 846–849.
23.
LevyR, ClaravallV.Differential effects of a phone reminder on appointment keeping for patients with long and short between-visit intervals. Med Care1977; 15: 435–438.
24.
BigbyJ, GiblinJ, PappiusEM, Appointment reminders to reduce no-show rates. A stratified analysis of their cost-effectiveness. JAMA1983; 250: 1742–1745.
25.
GatesSJ, ColbornDK. Lowering appointment failures in a neighborhood health center. Med Care1976; 14 263–267.
26.
GroverS, GagnonG, FlegelKM, Improving appointment-keeping by patients new to a hospital medical clinic with telephone or mailed reminders. Can Med Assoc J1983; 129: 1101–1103.
27.
HofmannPB, RockartJF. Implications of the no-show rate for scheduling OPD appointments. Hosp Progr1969; 50: 35–40.
28.
AmbuelJP, CebullaJ, WattN, . Urgency as a factor in clinic attendance. Am J Dis Child1964; 108: 394–398.
29.
NazarianLF, MechaberJ, CharneyE, Effect of mailed appointment reminder on appointment keeping. Pediatrics1974; 53: 349–352.
30.
BarkinRM, DuncanB.Broken appointments: questions, not answers. Pediatrics1975; 55: 747.
31.
ShinarakKL. Reduce your broken appointment rate: how one children-and-youth project reduced its broken appointment rate. Am J Public Health1971; 61: 2400–2404.
32.
ShepardDS, MoseleyTAIII. Mailed versus telephoned appointment reminders to reduce broken appointments in a hospital outpatient department. Med Care1976; 14: 268–273.
33.
MathaiJ, MarkantonakisA.Improving initial attendance to a child psychiatric clinic. Psychiatr Bull1990; 14: 151–152.
34.
StineOC, ChauquiC, JimenezC, Broken appointments at a comprehensive clinic for children. Med Care1968; 6: 332–339.
