Penn State Health study finds link between ‘no-show’ medical appointments and race, language
A Penn State Health study has revealed an association between missed medical appointments and race, ethnicity and language.
Termed “no-shows,” missed appointments without notification from the patient not only affect patients’ continuity of care and, potentially, their health outcomes, but also reduce access for other patients.
The study by diversity vice chairs of clinical departments at Penn State Health Milton S. Hershey Medical Center analyzed scheduled appointments during a six-month period, considering factors such as race, ethnicity, age, language and insurance across multiple clinical settings.
Age, race and ethnicity role
The study found that:
- Patients younger than 54 were three times more likely to miss appointments than those 65 and older.
- Patients who are Asian, American Indian and Pacific Islander were twice as likely to miss appointments than Caucasian patients.
- Black and Hispanic patients were three times more likely to miss appointments than Caucasian patients.
- Patients whose primary language is Spanish or Nepali were twice as likely to miss an appointment for care than English-speaking patients.
Missed appointments affect everyone
Missed appointments not only affect the care of the patient who doesn’t show up, but also affect a second patient who could have been scheduled for that time. In addition, no-show visits create a financial challenge for health systems because no fee can be collected for the appointment.
Previous no-show studies have linked missed appointments to social determinants of health such as low socioeconomic status, complex medical situations and mental illness. Of those studies, approximately 190 were limited to a specific specialty clinic or narrowly focused on a single insurance type, according to Maxwell Wright, a medical student at Penn State College of Medicine who assisted with the research. The Penn State Health study expanded the scope of research by looking at the impact of race and ethnicity across multiple clinical settings.
The diversity vice chairs will now develop recommendations on how to reduce no-shows. One potential step is to provide timely appointment reminders in languages other than English.
The study coincides with a Penn State Health initiative to provide language support for patients whose primary language is not English. The effort includes expanding the number of qualified medical interpreters, providing proficiency testing for employees who are bilingual, identifying health system employees who speak languages other than English and developing a robust language instruction program.
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