Abstract
BackgroundNon-attendance for hospital outpatient appointments is a significant problem in many countries. It causes suboptimal use of clinical and administrative staff and financial losses, as well as longer waiting times. The use of Short Message Service (SMS) appointment reminders potentially offers a cost-effective and time-efficient strategy to decrease non-attendance and so improve the efficiency of outpatient healthcare delivery.MethodsAn SMS text message was sent to patients with scheduled appointments between April and September 2006 in a hospital ophthalmology department in London, reminding them of their appointments. This group acted as the intervention group. Controls were patients with scheduled ophthalmology appointments who did not receive an SMS or any alternative reminder.ResultsDuring the period of the study, 11.2% (50/447) of patients who received an SMS appointment reminder were non-attenders, compared to 18.1% (1720/9512) who did not receive an SMS reminder. Non-attendance rates were 38% lower in patients who received an SMS reminder than in patients who did not receive a reminder (RR of non-attendance = 0.62; 95% CI = 0.48 – 0.80).ConclusionThe use of SMS reminders for ophthalmology outpatient appointments was associated with a reduction of 38% in the likelihood of patients not attending their appointments, compared to no appointment reminder. The use of SMS reminders may also be more cost-effective than traditional appointment reminders and require less labour. These findings should be confirmed with a more rigorous study design before a wider roll-out.
Highlights
Non-attendance for hospital outpatient appointments is a significant problem in many countries
Ethics committee approval was obtained from Barts and The London National Health Service (NHS) Trust for Short Message Service (SMS) reminders to be sent to patients
The absolute reduction in non-attendance rates for those who received an SMS reminder was 6.9%. This represents about 31 more being kept over a 6 month period that would have otherwise been lost through patients not keeping their scheduled appointments
Summary
Non-attendance for hospital outpatient appointments is a significant problem in many countries It causes suboptimal use of clinical and administrative staff and financial losses, as well as longer waiting times. Non-attendance for hospital outpatient appointments is a major burden on healthcare systems and costs the National Health Service (NHS) in the UK an estimated £790 million per year [1] It reduces the efficiency and effectiveness of the delivery of outpatient healthcare and causes substantial financial losses for healthcare systems [2]. It results in suboptimal use of clinical and administrative staff and results in increased waiting times for other patients [3]. There is a paucity of research in relation to the use of mobile phone SMS (Short Message Service)/text message reminders for outpatient hospital appointments [3]
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