Reasons for patients keeping or missing their appointments in family medicine in the United States: importance of no-show history in the previous year

Background: Missed appointments at primary care clinics are detrimental to patients' health and clinics' efficiency. We investigate reasons for no-shows, motivation to keep appointments and self-perception of health among patients with different no-show histories. Methods: Using archival data of patient visits (2018-2020) at Medical College of Georgia (MCG) Family Medicine Clinic (FMC) at Augusta University, we categorized patients based on the number of no-shows in the previous calendar year (Group 1 = zero; Group 2 = one or two; Group 3 = three or more). We gathered descriptive statistics on patient age, race, gender and insurance type and performed a regression analysis to estimate these factors' impact on the likelihood of shifting between groups. We administered FMC patients an anonymous survey on reasons for no-shows, motivations to keep appointments and self-perception of health. Results: Patients in Group 1 versus Groups 2 and 3 differed in self-perception of health and the presence of a household dependent. Reasons for no-shows indicate difficulties with timing of appointment and change in health status and suggest an association between no-shows and health status. The main motivation to keep the appointment in all three groups was health concerns. Conclusions: This study highlights the importance of distinguishing patients based on no-show history when designing no-show reduction interventions.