Impact of missed appointments for outpatient physiotherapy on cost, efficiency, and patients' recovery

Missed appointments (MAs) constitute a challenge for clinicians and clinical administrators. This study assessed the rates of MAs and their impact on cost, efficiency, and patients' recovery. A 3-year retrospective audit was conducted in a Nigerian outpatient physiotherapy clinic. Data were gleaned on socio-demographic and clinical variables related to MAs. Efficiency was calculated as current asset divided by current liability; while total revenue loss due to MAs was calculated as a product of the total of MAs and per treatment cost. Of 930 appointments, 79.2% were MAs. MAs for first, second and third treatment schedules were 26.1%, 34.1% and 32.3%, respectively. The proportion of MAs was higher among females (80.3%), the elderly (>65 years) (90.6%), patients with neurological conditions (91.3%) and appointments in the month of December (94.3%). If the per treatment schedule cost is $10, a 79.2% MAs rate will result in $7370 revenue loss and 737 lost opportunities to treat patients. MAs lowered efficiency by 79.0%, with an efficiency ratio of 0.21. If MAs slow a patient's recovery process by 2 days, then 79.2% of MAs could potentially impact patient recovery time by 1474 days. MAs for outpatient physiotherapy are a momentous challenge and signify important losses in terms of cost, efficiency and recovery time for patients.Copyright (C) 2012, Hong Kong Physiotherapy Association Ltd. Published by Elsevier (Singapore) Pte Ltd. All rights reserved.