Methods to Reduce Outpatient Non-attendance

Non-attendance reduces clinic and provider productivity and efficiency, compromises access and increases cost of health care. This systematic review of the English language literature (November 1999–November 2009) compares telephone, mail, text/short message service, electronic mail and open-access scheduling to determine which is best at reducing outpatient non-attendance and providing net financial benefit. Telephone, mail and text/short message service interventions all improved attendance modestly but at varying costs. Text messaging was the most cost-effective of the 3, but its applicability may be limited. Few data are available regarding electronic mail reminders, whereas open-access scheduling is an area of active research.