There have been many advances in health care. The development of new drugs, the introduction of new techniques and technologies for medical diagnosis, and more widespread promotion of preventive measures such as vaccination are good examples of health care advances seen in recent decades. However, nonattendance for scheduled appointments remains a challenge to health care managers and providers because it can hamper patient treatment [1], [2].
Nonattendance for scheduled appointments can result from many factors. Some authors [3], [4] report that the main reasons are forgetting, work obligations, the need to look after children, transportation difficulties, and appointment costs. Other authors [2] report that mixing up appointment dates, times, and locations is the main reason for missing appointments.
In their study, Lacy et al. [3] assessed the reasons patients gave for missing medical appointments. These authors claim that keeping
A private company, Katu Company, and the Department of Health Informatics at Federal University of São Paulo established a partnership to implement and maintain two electronic medical record systems, Clinic Manager® [12] and its related Web version, Clinic Web®. A compatible module was developed for sending reminders as SMS text messages to patients’ cell phones, with cost about US$ 10,000. It has been operating since June 2007. This module is based on open, low-cost technologies including
Table 1 lists the number of SMS reminders sent for each of the five clinics during the study period, it is also shown the number of appointments of these outpatient clinics.
Clinic 4 was excluded from the analysis because it did not meet the criteria for attendance ascertainment defined earlier. The present analysis includes data from Clinics 1, 2, 3, and 5.
Fig. 3 shows the mean rates of nonattendance to general consultations and first visits during the period studied, regardless of whether an
When an appointment is scheduled at a medical outpatient clinic, resources are allocated for seeing the patient at that time. Whether the patient attends an appointment or not, the costs of rent, provider salaries, and other resources must be covered. Patients missing appointments are more likely to discontinue their medical treatment and less likely to receive adequate and timely intervention. Therefore, strategies to reduce patient nonattendance at appointments are crucial to improve the
SMS appointment reminders sent to patients have proven to be an effective, easy strategy [2]. In the present study, data on thousands of appointments collected from four medical outpatient clinics in São Paulo were analyzed and supported the potential of SMS reminders to reduce nonattendance for appointments.
When a patient attends a scheduled appointment both the health care facility and the patient benefit. Besides using the appointment time to provide care to a patient, the facility avoids
We thank Katu Company and its collaborators for supporting the database to this research. Summary points What was already known on the topic: We did not find any evidence on specialized literature concerning SMS text messages sent as appointment reminders to patients’ cell phones in developing countries; There are some authors who show potential benefits on using SMS to improve attendance rates, although in restricted scenarios. What this study added to our knowledge: This study added positive,
