Predictors of Failed Orthodontic Appointments

Missed orthodontic appointments extend treatment time and increase the risk of adverse side effects while decreasing practitioner productivity. Objectives: The purpose of this study was to determine factors related to missed orthodontic appointments. Methods: Appointment attendance was tracked as “kept” or “not kept” (missed or same day rescheduled) retroactively over a 6 week period for active, non-Medicaid patients at the VCU orthodontic clinic. Independent variables included age of the patient (adult, minor), gender, appointment type (bonding, adjustment, debonding, appliance delivery), scheduling method (in person, phone, postcard), and financial status (current, overdue, collections). For patients that did not keep their appointment, rescheduled appointment characteristics were followed. Results: 538 appointments were tracked. Failure rates were significantly higher for males (16.2%; P<0.02) than females (9.5%). Appointments made by postcard were missed significantly more often (28.2%; P<0.003) than those made in person (11.9%) or by phone (6.5%). Patients who were overdue on payments (33.3%) or in collections (28.6%) were significantly more likely to miss appointments than those whose accounts were current (10.5%; P<0.0001). Age and appointment type were not significantly related to attendance (P>0.10 for both). Rescheduled appointments were kept 69.7% of the time regardless of financial status (P>0.10) or scheduling method (P>0.10). Conclusion: Patients behind on their bills are more likely to miss orthodontic appointments. Other predictors of failed appointments include scheduling by postcard and male gender. Communication of the importance of keeping appointments, even in the presence of overdue payments, may be helpful. Telephone reminders, especially if appointments are scheduled by postcard, may improve attendance. (This study was supported in part by the AD Williams Fund of VCU and the MCV Orthodontic Education and Research Foundation)