OBJECTIVE: This study investigated reasons for missed psychiatric
appointments, rescheduling of appointments, adverse outcomes, and the
association of specific diagnoses and treatments with missed appointments.
METHOD: A prospective survey covering all individual outpatient visits to
seven mental health clinic psychiatrists was conducted during a 3-month
period in 1991. Of the 1,620 scheduled visits, 142 (8.8%) were missed,
representing 130 separate patients. For each missed appointment, the
psychiatrist involved completed a questionnaire on the type of visit, the
patient's DSM-III-R diagnosis, the reason for missing the appointment, the
date of patient recontact, and adverse outcome, if any. RESULTS: Of the 142
missed appointments, 71.1% were rescheduled spontaneously by the patients;
of these, most (73.3%) were rescheduled within 2 weeks. The remaining
missed appointments represented various outcomes, including dropping out of
treatment. The most common stated reason for missing an appointment was
patient error, such as forgetting, oversleeping, or getting the date wrong.
Patients with PTSD and/or substance abuse were significantly more likely
than others to miss appointments, and those with major depression were
somewhat less likely to do so. CONCLUSIONS: Most patients quickly
reschedule missed appointments, and those in more intensive treatments miss
fewer appointments. Missed appointments for initial evaluation are not
rescheduled most often. Patients in ongoing treatment who do not return may
have histories of noncompliance with treatment. The high rate of
rescheduling suggests that follow-up of patients who miss appointments
should be a clinical decision rather than a routine policy.