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Article
October 7, 1983

Appointment Reminders to Reduce No-Show Rates: A Stratified Analysis of Their Cost-effectiveness

Author Affiliations

From the Department of Medicine and the Henry J. Kaiser Family Foundation Fellowship Program in General Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston.

JAMA. 1983;250(13):1742-1745. doi:10.1001/jama.1983.03340130060033
Abstract

To determine whether reminders are cost-effective for an adult primary care internal medicine center, we randomized 590 scheduled, follow-up appointments to no reminder, computer-generated letter reminders, and telephoned reminders. The no-show rate was reduced from 24% in the control group to 14% in the reminder groups, and letter and telephoned reminders were equally effective. An economic analysis showed that about two thirds of the savings realized from reminders was generated in 23% of the patients whose prior predicted probability of a no-show appointment was above 20%. However, in our primary care center, computer-generated letter reminders were estimated to be cost-effective whenever the probability of a no-show was above 5%, and telephoned or manual letter reminders were estimated to be cost-effective whenever the probability of a no-show was above about 11%. Based on our sensitivity analysis, telephoned or manual letter reminders should be cost-effective in many other ambulatory settings as well, although in some settings, reminders may be restricted to patients at high risk for no-show behavior.

(JAMA 1983;250:1742-1745)

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