Non-attendance or non-invitation? A case-control study of failed outpatient appointments.

Abstract
OBJECTIVE--To determine the causes of non-attendance at new outpatient appointments. DESIGN--Case-control study of non-attenders and attenders. SETTING--Outpatient department of a general hospital. SUBJECTS--All non-attenders (n = 277) for first outpatient appointments in six specialties during a three month period were included. Controls (n = 135) were the attenders who followed every second non-attender; thus they attended the same consultant on the same day that the non-attenders were expected. INTERVENTIONS--None. MEASUREMENTS AND MAIN RESULTS--Information on the clinical problem, difficulties in attending the hospital, and reasons for non-attendance from the questionnaire were coded and classified. Non-attenders had received shorter notice of their appointment than attenders (14% v 1% had received three days' notice or less). There were small differences in the seriousness of patients' clinical condition. CONCLUSIONS--Client factors are less important than aspects of the service in explaining non-attendance at outpatient appointments.