Improving Non-attendance Rates Among Pediatric Patients with Medicaid or Private Insurance

Publication date: Available online 13 February 2019

Source: Journal of the American Academy of Dermatology

Author(s): Sofia B. Chaudhry, Elaine Siegfried, Umar A. Sheikh, Cassandra Simonetta, Niraj Butala, Eric Armbrecht

Abstract

Background

Access to dermatologists by Medicaid-insured patients is low. Higher clinic non-attendance (NA) among Medicaid-insured patients may impact provider decisions to accept these patients.

Objectives

To determine the effect of different scheduling policies on the NA among children seen at a pediatric dermatology clinic.

Methods

This retrospective review compared NA for three different scheduling policies implemented over 3 consecutive years. Scheduling policies utilized were a first-available open scheduling, a 2-week in advance and a 4-week in advance scheduling policy. Subset analysis was performed by clinic location and insurance type.

Results

The interval between scheduling and appointment date was directly related to NA rates, with higher rates for Medicaid-insured, compared to privately-insured patients. Open scheduling was associated with a 37% NA rate for Medicaid-insured, compared to 18% for privately-insured patients. A 4-week scheduling policy significantly decreased the Medicaid NA rate to 19%, compared to 7% for privately-insured patients. A 2-week policy further decreased the NA rate to 11% for Medicaid and 4% for privately insured patients.

Limitations

Retrospective study that could not track same-day cancellations.

Conclusions

Decreasing the interval between scheduling and appointment dates can significantly decrease NA. This strategy may help dermatologists incorporate more Medicaid-insured patients into their practice.

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