GETTING PATIENTS IN THE DOOR: MEDICAL APPOINTMENT REMINDER PREFERENCES

Purpose:

   Missed appointments result in unnecessary costs and inefficiencies in the U.S. healthcare system. Appointment reminders may help reduce missed appointments. We used a discrete choice experiment (DCE) to assess reminder preferences and a survey to learn why individuals miss appointments.

Method:

   We used the literature and preliminary data to develop a DCE to examine four attributes of possible medical appointment reminders: 1) initial reminder type (postal mail, phone call, text message, email, social media, or electronic calendar); 2) arrival of initial reminder (1-6 days, 1-2 weeks, 3-4 weeks, or greater than one month prior); 3) reminder content (clinic location only, rescheduling information only, reason for visit only, clinic location and rescheduling information, rescheduling information and reason for visit, or clinic location, rescheduling information and reason for visit) and 4) number of reminders (1 reminder, 2-3 reminders – same type, 2-3 reminders – different type). We recruited a national sample of US adults 18 or older from an online survey panel. Participants received information about appointment reminder features, then completed a 16 task DCE and survey with questions about appointment habits. We used Sawtooth Software’s online Discover software which employs Empirical Bayesian methods to analyze responses to produce importance scores and utilities for the 4 attributes.   

Result:

   We surveyed 251 U.S. adults, mean age was 43 (range 18-83); 51% female; 84% White and 8% African American. Twenty-three percent of individuals missed one or more appointments in the past 12 months. Primary reasons for missing an appointment were transportation problems (28%), forgetfulness (26%) and confusion over time, date or location (14%). Participants found the initial reminder type (44%) to be most important, followed by reminder content (24%), arrival of initial reminder (21%), and number of reminders (10%). Overall participants indicated a preference for a single reminder arriving by way of either email, phone call or text message, delivered less than two weeks prior to an appointment. Participants had less distinct preferences for reminder content.  Participants wanted reminders to contain either the most essential information or all available information.

Conclusion:

   Appointment reminders address some of the reasons individuals report missing appointments. Patient-centered reminders that consider individual patients’ preferences may result in improved appointment attendance.