The effect of reminder calls in reducing non-attendance rates at care of the elderly clinics
F Dockerya, C Rajkumara, C Chapmana, C Bulpitta, C Nichollb
a Department of
Medicine for the Elderly, Hammersmith Hospital, Du Cane Road, London
W12 OHS, UK, b Department of Medicine for the
Elderly, Addenbrooke's Hospital, Hills Road, Cambridge CB2 2QQ,
UK
Correspondence to: Dr Frances Dockery, Department of Medicine for the Elderly, Charing Cross Hospital, Fulham Palace Road, London W6 8RF, UK fdockery{at}doctors.org.uk
Submitted 3 March 2000;
Accepted 28 June 2000
BACKGROUND
DNA ("did
not attend") at outpatient clinics is an important problem costing
the NHS an estimated £266 million annually. The national DNA rate for
1996-1997 for all clinics was 12%. The DNA rate at Hammersmith
Hospital for the same year in the care of the elderly specialty was
21%. The aim of this study was to establish why this was so, and to
test the efficacy of a reminder call in increasing attendance rates at
care of the elderly clinics.
METHODS23 DNAs from
seven clinics were contacted to ascertain the reasons for
non-attendance (group I). For seven further clinics, 84 patients were
contacted in advance to reconfirm their appointment (group II).
RESULTSFrom group II
12 patients were identified who were unaware of their appointment
(14%), six of whom agreed to attend; thus six potential DNAs were
prevented. Eleven vacant appointments were identified in advance. The
unexpected DNA rate was reduced to 5% from
a potential 21% as a result of this exercise. The DNA rate for all
patients with dementia (both groups) was 44%, whereas the DNA rate for
all patients without this diagnosis (both groups) was 16%
(p < 0.001).
CONCLUSIONSA
preclinic phone call reminder to elderly patients is feasible,
increases attendance rates, and identifies vacant appointments. Patients with dementia are more likely to miss clinic appointments; therefore they and their carers need specific reminders about appointment dates.
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Key points
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Keywords: outpatient clinics; attendance rates; elderly patients; dementia
© 2001 by The Fellowship of Postgraduate Medicine
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