Effectiveness of telephone reminders in improving rate of appointments kept at an outpatient clinic: a randomized controlled trial

BACKGROUND: Clinic appointments in which patients do not appear (no-show) result in loss of provider time and revenue. Previous studies have shown variable effectiveness in telephone and mailed reminders to patients. METHODS: We conducted a randomized controlled trial of telephone reminders 1 day before the scheduled appointments in an urban family practice residency clinic. Patients with appointments were randomized to be telephoned 1 day before the scheduled visit; 479 patients were telephoned and 424 patients were not telephoned. RESULTS: The proportions of patients not showing up for their appointments were 19% in the telephoned and 26% in the not-telephoned groups (P = .0065). Significantly more cancelations were made when telephoning patients before their visit, 17% compared with 9.9%. The opened scheduling slots were used for appointments for other patients. This additional revenue offset the cost of telephone intervention in our cost analysis. CONCLUSION: Reminding patients by telephone calls 1 day before their appointments yields increased cancelations that can be used to schedule other patients. Telephone reminders provide substantial net revenue, but the results may be population specific.