Appointment reminders to reduce no-show rates. A stratified analysis of their cost-effectiveness
J. Bigby, J. Giblin, E. M. Pappius and L. Goldman
To determine whether reminders are cost-effective for an adult primary care
internal medicine center, we randomized 590 scheduled, follow-up
appointments to no reminder, computer-generated letter reminders, and
telephoned reminders. The no-show rate was reduced from 24% in the control
group to 14% in the reminder groups, and letter and telephoned reminders
were equally effective. An economic analysis showed that about two thirds
of the savings realized from reminders was generated in 23% of the patients
whose prior predicted probability of a no-show appointment was above 20%.
However, in our primary care center, computer-generated letter reminders
were estimated to be cost-effective whenever the probability of a no-show
was above 5%, and telephoned or manual letter reminders were estimated to
be cost-effective whenever the probability of a no-show was above about
11%. Based on our sensitivity analysis, telephoned or manual letter
reminders should be cost-effective in many other ambulatory settings as
well, although in some settings, reminders may be restricted to patients at
high risk for no-show behavior.
