Differential Effects of a Phone Reminder on Appointment Keeping for Patients with Long and Short Between-Visit Intervals

In the Harborview Medical Center pediatrics clinic, we were interested in testing whether a phone call would increase appointment-keeping behavior and whether the call would have a differential effect depending on the interval between appointments. Ninety-eight patients were studied who had scheduled appointments 3 to 264 days in advance and still had these appointments 3 days prior to appointment time. Patients who were randomly placed in an experimental condition received a reminder call. Control patients received no call. The results indicate some difference between compliance rates of the experimental and control conditions in the expected direction (X2 = 3.715, df = 1, p < .05). Patients whose visits were scheduled more than 14 days prior to the appointment time ("long-interval" patients) were separated from patients whose appointments were scheduled more recently. A significant difference in appointment-keeping rates between the experimental and control groups was found (X2 = 4.908, df = 1, p < .025), but only for the "long-interval" patients. Therefore, the use of a phone cue is particularly recommended for these patients. A SUBSTANTIAL BODY of literature now exists on patient compliance, or noncompliance, in medical practice. Patient behavior has been studied most frequently for medication taking, diet and exercise adherence, and appointment keeping. In the pediatrics clinic of Harborview Medical Center, appointment keeping has typically been less than 50 per cent.1 When large numbers of patients do not show up for scheduled appointments after an initial visit, medical professionals cannot even begin to assess compliance with other aspects of the treat