Missed Appointment in Adolescent Clinic; Perspective
from Tertiary Care Hospital, Thailand
Thanyalak Intachote BNS, MEd*,
Tidarat Choowong BSW, MS**, Supinya In-iw MD**,
Jedsada Suwanwaree BPH**, Boonying Manaboriboon MD**
Affiliation :
* Department of Pediatric Nursing, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
** Department of Pediatrics, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To determine the missed appointment rate and evaluate the factors related to appointment adherence in adolescent
patients, based on the patients’ characters and services provided.
Material and Method: All medical records in adolescent clinic at Siriraj Hospital between 2004 and 2009 were reviewed.
Patients that visited the clinic at least twice with the follow-up visit order were recruited. Data analyses were performed
by Chi-square test and Fisher’s exact test wherever appropriated.
Results : One hundred twenty six patients met the inclusion criteria. Patients’ mean age were 14.3-year-old (SD = 2.7) and
the majority (95%) were students. Seventy one point five percent of principle diagnosis related to behavioral problems while
90% had at least one risky behavior detected. Comparing between missed and non-missed appointment, only the acute
illness and the history of appointment cancellation were significant different characters between groups (p<0.001). Of
429 visits, 409 (95.3%) got telephone reminder a few days prior the appointment date, 48 (11.2%) remained non-complying
and 40 (9.7%) had rescheduled. Only 18 (4.2%) of the visits were the patients themselves made re-appointments, which all
complied with the new visit. Having rescheduled after being reminded and having history of a missed previous appointment
were the most significant predictors for next appointment adherence (p = 0.01 and p = 0.02 respectively).
Conclusion : In adolescents, appointment non-compliance is a challenging issue for clinicians. Predicting factors found in
this study might help foster appointment adherence. Interestingly, services provided such as telephone reminder, short
waiting time, appointment time did not influence adherence in this population.
Keywords : Outpatient, Missed appointments, Adolescents, Appointment adherence, Appointment, Compliance
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