Improving nonattendance rates among pediatric patients with Medicaid or private insurance

• Published in: Journal of the American Academy of Dermatology Vol. 81; no. 2; pp. 412 - 416
• Main Authors: Chaudhry, Sofia B., Siegfried, Elaine, Sheikh, Umar A., Simonetta, Cassandra, Butala, Niraj, Armbrecht, Eric
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.08.2019
• Subjects: Adolescent; Appointments and Schedules; Child; Child, Preschool; children; commercial insurance; Dermatology - organization & administration; Dermatology - statistics & numerical data; Humans; Infant; Infant, Newborn; Insurance, Health - statistics & numerical data; Medicaid; Medicaid - statistics & numerical data; no-show; No-Show Patients - statistics & numerical data; nonattendance; pediatric; private insurance; Retrospective Studies; Time Factors; United States; United States; children; nonattendance; private insurance; commercial insurance; Medicaid; no-show; pediatric
• ISSN: 0190-9622; 1097-6787
• DOI: 10.1016/j.jaad.2019.02.018

Access to dermatologists is low among Medicaid-insured patients. Higher clinic nonattendance among Medicaid-insured patients might affect provider decisions to accept these patients. To determine the effect of different scheduling policies on the attendance among children seen at a pediatric dermatology clinic. In this retrospective review, we compared nonattendance among children for 3 different scheduling policies implemented over 3 consecutive years. The scheduling policies used were a first-available open scheduling policy, a 2-week in advance scheduling policy, and a 4-week in advance scheduling policy. Subset analyses were performed by clinic location and insurance type. The interval between scheduling and appointment date was directly related to nonattendance rates; rates were higher for Medicaid-insured than privately insured patients. Open scheduling was associated with a 37% nonattendance rate for Medicaid-insured patients and 18% nonattendance rate for privately insured patients. A 4-week in advance scheduling policy significantly decreased the nonattendance rate to 19% among Medicaid-insured and 7% among privately insured patients. A 2-week in advance policy further decreased the nonattendance rate to 11% among Medicaid-insured patients and 4% among privately insured patients. This is a retrospective study, and same-day cancellations were not tracked. Decreasing the time interval between scheduling and appointment dates can significantly decrease nonattendance. This strategy might help dermatologists incorporate more Medicaid-insured patients into their practices.