Among patients who fail to show up for screening mammography, nearly half do not return within one year after the missed appointment, according to research published Monday.
Patients who are black or from socioeconomically disadvantaged populations are more likely to experience such no-shows. Other factors also can influence attendance rates, including language barriers and insurance status, experts detailed in the Journal of the American College of Radiology [1].
“Our data indicate screening mammography appointment no-shows is a health equity issue where socioeconomically disadvantaged and racial and ethnic minority patients are disproportionately more likely to experience missed appointments and potential care delays,” lead author Gary X. Wang, MD, PhD, with the Department of Radiology at Massachusetts General Hospital, and colleagues wrote April 8.
Boston-based researchers gathered their data from a single Mass General community health center, with appointments spanning all of 2021. Out of 6,159 individuals included in the study, about 12% did not show up for their screening appointment. This group of 743 individuals differed from the other 88% in their language, race and ethnicity insurance type and poverty. Those who did not attend often spoke a language other than English (32% vs. 27% among those who underwent screening) were a race and ethnicity other than white non-Hispanic (42% vs. 34%), had Medicaid or other means-tested insurance (62% vs. 34%).
Independent predictors of patient now-shows included black/non-Hispanic race and ethnicity, Medicaid or other such insurance, and higher poverty. Roughly 41% (or 302/743) of patients with no-shows still had not completed screening mammography a year after the original appointment.
To improve these numbers, Mass General is investigating an intervention that provides targeted rescheduling outreach to patients following a no-show. They’ll also explore other solutions to reduce the no-show rate, such as pre-appointment reminders. Wang et al. believe this is a key issue to address, as unused appointments can result in financial costs for the healthcare system, reduced patient access and worse health outcomes.
“Our findings point to a clear need to better understand the patient population who do not complete screening mammography following appointment no-shows,” the authors advised. “Specifically, we are currently undertaking efforts to characterize this population and to understand their barriers and facilitators to scheduling and completing screening mammography at our institution. Prior studies have shown regular contact with primary care providers to be associated with increased screening mammography use. Accordingly, it will be important in the future to understand how primary care engagement is associated with appointment no-shows and subsequent mammography completion.”
Read more at the link below, including any potential study limitations.
Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic.