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Predictors of missed appointments in patients referred for congenital or pediatric cardiac magnetic resonance

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Abstract

Background

Congenital cardiac magnetic resonance is a limited resource because of scanner and physician availability. Missed appointments decrease scheduling efficiency, have financial implications and represent missed care opportunities.

Objective

To characterize the rate of missed appointments and identify modifiable predictors.

Materials and methods

This single-center retrospective study included all patients with outpatient congenital or pediatric cardiac MR appointments from Jan. 1, 2014, through Dec. 31, 2015. We identified missed appointments (no-shows or same-day cancellations) from the electronic medical record. We obtained demographic and clinical factors from the medical record and assessed socioeconomic factors by U.S. Census block data by patient ZIP code. Statistically significant variables (P<0.05) were included into a multivariable analysis.

Results

Of 795 outpatients (median age 18.5 years, interquartile range 13.4–27.1 years) referred for congenital cardiac MR, a total of 91 patients (11.4%) missed appointments; 28 (3.5%) missed multiple appointments. Reason for missed appointment could be identified in only 38 patients (42%), but of these, 28 (74%) were preventable or could have been identified prior to the appointment. In multivariable analysis, independent predictors of missed appointments were referral by a non-cardiologist (adjusted odds ratio [AOR] 5.8, P=0.0002), referral for research (AOR 3.6, P=0.01), having public insurance (AOR 2.1, P=0.004), and having scheduled cardiac MR from November to April (AOR 1.8, P=0.01).

Conclusion

Demographic factors can identify patients at higher risk for missing appointments. These data may inform initiatives to limit missed appointments, such as targeted education of referring providers and patients. Further data are needed to evaluate the efficacy of potential interventions.

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Acknowledgments

The authors would like to acknowledge Katrice Yarrington, who performed the initial search of the electronic medical record for missed appointments.

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Authors and Affiliations

  1. Department of Pediatrics and Communicable Diseases, Division of Pediatric Cardiology, University of Michigan Health System, University of Michigan Congenital Heart Center, C. S. Mott Children’s Hospital, 1540 E. Hospital Drive, Ann Arbor, MI, 48109-4204, USA

    Jimmy C . Lu, Ray Lowery, Sunkyung Yu & Adam L. Dorfman

  2. Department of Radiology, University of Michigan Health System, Section of Pediatric Radiology, C. S. Mott Children’s Hospital, Ann Arbor, MI, USA

    Jimmy C . Lu, Maryam Ghadimi Mahani & Adam L. Dorfman

  3. Department of Radiology, Division of Cardiothoracic Radiology, University of Michigan Health System, Ann Arbor, MI, USA

    Prachi P. Agarwal

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  1. Jimmy C . Lu
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  2. Ray Lowery
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  3. Sunkyung Yu
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  4. Maryam Ghadimi Mahani
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  6. Adam L. Dorfman
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Correspondence to Jimmy C . Lu.

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Lu, J.C..., Lowery, R., Yu, S. et al. Predictors of missed appointments in patients referred for congenital or pediatric cardiac magnetic resonance. Pediatr Radiol 47, 911–916 (2017). https://doi.org/10.1007/s00247-017-3851-8

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  • DOI: https://doi.org/10.1007/s00247-017-3851-8

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