John Zeber, Dana Pearson and Danielle Smith carried out research into why patients do not show up to appointments in community health centres and examined what can be done to improve attendance rates

A community health centre in the United States was becoming increasingly frustrated at the high prevalence of no-show appointments: nearly one-third of all patients failed to keep scheduled visits. In addition to potential health ramifications, this scenario represented a major source of lost revenue, inefficient use of clinical resources, and difficulty recruiting physicians and qualified personnel. Serving a diverse, underprivileged population, significant no-show rates jeopardise a clinic’s ability to appropriately treat vulnerable patients. This includes inappropriate monitoring of chronic conditions such as diabetes (Karter et al 2004), and a significantly higher risk of hospital readmission (Nelson et al 2000). The financial costs associated with no-show appointments can total nearly 15 per cent of a clinic’s annual income (Moore et al 2001).