No-shows in outpatient clinics disrupt both the scheduling and the efficiency of medical services. Addressing this critical issue is essential to enhancing patient care and ensuring clinic productivity. A recent systematic review examined how implementing an open access (OA) scheduling system influences the rate of missed appointments, offering valuable insights into its effectiveness across various medical specialties.
Comprehensive Systematic Review
The investigation delved into English-language articles sourced from PubMed, Scopus, Web of Science, and Google Scholar, focusing on studies that employed OA systems and reported no-show rates. Excluded from this review were opinion pieces, review articles, and studies on inpatient scheduling or those simulating OA systems. Data from these selected articles were meticulously extracted, covering aspects such as study design, outcome measures, interventions, results, and quality scores.
Key Findings and Implications
Out of 23,403 studies, 16 met the inclusion criteria. These studies spanned multiple specialties, including family medicine, pediatrics, ophthalmology, podiatry, geriatrics, internal medicine, and primary care. The results revealed that 62.5% of the articles (10 out of 16) reported a significant reduction in the no-show rates with the implementation of OA scheduling. Conversely, 25% (four articles) observed no significant reduction, and 12.5% (two articles) found no notable change.
The substantial reduction in no-show rates highlights the potential of OA scheduling to improve clinic efficiency and patient access. However, the variability in outcomes suggests that OA systems must be tailored to the specific needs of different medical fields and patient populations. This customization is crucial for maximizing the benefits of OA scheduling and addressing unique challenges in various healthcare settings.
From a market access perspective, the adoption of OA scheduling systems can be seen as a strategic move to enhance patient throughput and clinic utilization. By reducing no-show rates, clinics can optimize appointment slots, leading to better resource allocation and potentially higher revenue. This approach not only improves patient satisfaction but also ensures that healthcare providers can deliver timely and efficient care.
Valuable Inferences
The study offers several concrete inferences for healthcare stakeholders:
- OA scheduling systems can significantly reduce no-show rates, especially in family medicine and pediatrics.
- Tailoring OA systems to specific clinic needs is essential for achieving optimal results.
- Consistent training and cooperation among stakeholders enhance the effectiveness of OA implementation.
- Reduced no-shows lead to better clinic utilization and resource management, benefiting both providers and patients.
In conclusion, the systematic review underscores the potential of OA scheduling systems to mitigate the issue of missed appointments in outpatient clinics. Tailored implementation and stakeholder cooperation are critical factors that contribute to the success of OA systems. This approach not only improves clinic efficiency but also enhances patient access to healthcare services.
Original Article:
Health Sci Rep. 2024 Jul 9;7(7):e2160. doi: 10.1002/hsr2.2160. eCollection 2024 Jul.
ABSTRACT
BACKGROUND: Patients’ missed appointments can cause interference in the functions of the clinics and the visit of other patients. One of the most effective strategies to solve the problem of no-show rate is the use of an open access scheduling system (OA). This systematic review was conducted with the aim of investigating the impact of OA on the rate of no-show of patients in outpatient clinics.
METHODS: Relevant articles in English were investigated based on the keywords in title and abstract using PubMed, Scopus, and Web of Science databases and Google Scholar search engine (July 23, 2023). The articles using OA and reporting the no-show rate were included. Exclusion criteria were as follows: (1) review articles, opinion, and letters, (2) inpatient scheduling system articles, and (3) modeling or simulating OA articles. Data were extracted from the selected articles about such issues as study design, outcome measures, interventions, results, and quality score.
FINDINGS: From a total of 23,403 studies, 16 articles were selected. The specialized fields included family medicine (62.5%, 10), pediatrics (25%, four), ophthalmology, podiatric, geriatrics, internal medicine, and primary care (6.25%, one). Of 16 articles, 10 papers (62.5%) showed a significant decrease in the no-show rate. In four articles (25%), the no-show rate was not significantly reduced. In two papers (12.5%), there were no significant changes.
CONCLUSIONS: According to this study results, it seems that in most outpatient clinics, the use of OA by considering some conditions such as conducting needs assessment and system design based on the patients’ and providers’ actual needs, and cooperating of all system stakeholders through consistent training caused a significant decrease in the no-show rate.
PMID:38983686 | PMC:PMC11231932 | DOI:10.1002/hsr2.2160
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