Original Article
Toward a better understanding of dental appointment-keeping behavior
Adrienne Lapidos,
H. Luke Shaefer,
Anne Gwozdek,
Corresponding Author
Adrienne Lapidos
School of Social Work, University of Michigan, Ann Arbor, MI, USA
Adrienne Lapidos, School of Social Work, University of Michigan, 1080 South University, 48109, Ann Arbor, MI, USA
Tel.: 1-734-764-6686
Fax: 1-734-763-3372
e-mail: [email protected]
Search for more papers by this authorH. Luke Shaefer
School of Social Work, University of Michigan, Ann Arbor, MI, USA
Search for more papers by this authorAnne Gwozdek
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
Search for more papers by this authorAdrienne Lapidos,
H. Luke Shaefer,
Anne Gwozdek,
Corresponding Author
Adrienne Lapidos
School of Social Work, University of Michigan, Ann Arbor, MI, USA
Adrienne Lapidos, School of Social Work, University of Michigan, 1080 South University, 48109, Ann Arbor, MI, USA
Tel.: 1-734-764-6686
Fax: 1-734-763-3372
e-mail: [email protected]
Search for more papers by this authorH. Luke Shaefer
School of Social Work, University of Michigan, Ann Arbor, MI, USA
Search for more papers by this authorAnne Gwozdek
Department of Periodontics and Oral Medicine, School of Dentistry, University of Michigan, Ann Arbor, MI, USA
Search for more papers by this authorAbstract
Objective
Broken appointments cause adverse outcomes in healthcare systems: They interrupt continuity of care, waste resources, affect workflow, and reduce population-wide access to care. A better understanding of dental appointment-keeping behavior would support efforts toward designing novel interventions aimed at reducing rates of broken appointments.
Methods
The authors conducted a conceptual review of quantitative and qualitative research on dental appointment-keeping in the United States.
Results
Research in this area is limited. Providers tend to use a blunt instrument to improve appointment-keeping: a system of reminder calls. There is evidence that patients with higher rates of broken dental appointments are the very ones who are most in need of care. Appointment-keeping barriers are multifactorial and related to social issues. They can be described as falling into three overlapping categories: psychological barriers, structural barriers, and health literacy barriers.
Conclusions
Appointment-keeping interventions could simultaneously address social factors that exacerbate illness and improve workflow and finances. There arises an opportunity to design innovative patient-centered interventions tailored to particular barriers.
References
- 1Maserejian NN, Trachtenberg F, Link C, Tavares M. Underutilization of dental care when it is freely available: a prospective study of the New England Children's Amalgam Trial. J Public Health Dent 2008; 68: 139–48.
- 2 Institute for Health Technology Transformation. Population health management: a roadmap for provider-based automation in a new era of healthcare. New York (NY): Institute for Health Technology Transformation, 2015; 24.
- 3Andersen R, Newman JF. Societal and individual determinants of medical care utilization in the United States. Milbank Q 2005; 83: e1–27.
10.1111/j.1468-0009.2005.00428.x Google Scholar
- 4Guay AH. The differences between dental and medical care. J Am Dent Assoc 2006; 137: 801–6.
- 5Yarbrough C, Nasseh K, Vujicic M. Why adults forgo dental care: evidence from a new national survey. Health Policy Institute Research Brief. American Dental Association, November 2014.
- 6Jones E, Shi L, Hayashi AS, Sharma R, Daly C, Ngo-Metzger Q. Access to oral health care: the role of federally qualified health centers in addressing disparities and expanding access. Am J Public Health Dent 2013; 103: 488–93.
- 7Mathu-Muju KR, Li HF, Hicks J, Nash DA, Kaplan A, Bush HM. Identifying demographic variables related to failed dental appointments in a university hospital-based residency program. Pediatr Dent 2014; 36: 296–301.
- 8Casaverde NB, Douglass JM. The effect of care coordination on pediatric dental patient attendance. J Dent Child 2006; 74: 124–9.
- 9Holtzman JS, Atchison KA, Gironda MW, Radbod R, Gornbein J. The association between oral health literacy and failed appointments in adults attending a university-based general dental clinic. Community Dent Oral Epidemiol 2014; 42: 263–70.
- 10Milgrom P, Fiset L, Melnick S, Weinstein P. The prevalence and practice management consequences of dental fear in a major US city. J Am Dent Assoc 1988; 116: 641–7.
- 11Fiset L, Milgrom P, Weinstein P, Melnick S. Common fears and their relationship to dental fear and utilization of the dentist. Anesth Prog 1989; 36: 258–64.
- 12Lin KC. Behavior-associated self-report items in patient charts as predictors of dental appointment avoidance. J Dent Educ 2009; 73: 218–24.
- 13Abdus-Salaam H, Davis LB. Impact of batch appointments on no-show rates: a public vs private clinic perspective. Health Syst 2012; 1: 36–45.
10.1057/hs.2012.4 Google Scholar
- 14Kuthy RA, Jones M, Kavand G, Momany E, Askelson N, Chi D et al. Time until first dental caries for young children first seen in Federally Qualified Health Centers: a retrospective cohort study. Community Dent Oral Epidemiol 2014; 42: 300–10.
- 15McCunniff M, Damiano PC, Daneman B, Willard JC, Momany ET. Evaluation of the Missouri Dental Medicaid Program. Jefferson City (MO): Missouri Department of Health, Bureau of Dental Health, 1999; 179.
- 16Davis RG, Fox M, Johnston J, Langner B, McAdams R, Moore J et al. Status and prospects for Medicaid beneficiaries' access to dental services in Kansas. Kansas City, MO: Health Services Research, 1999; 63.
- 17Lam M, Riedy CA, Milgrom P. Improving access for Medicaid-insured children: focus on front-office personnel. J Am Dent Assoc 1999; 130: 365–73.
- 18Im JL, Phillips C, Lee J, Beane R. The North Carolina Medicaid program: participation and perceptions among practicing orthodontists. Am J Orthod and Dentofacial Orthop 2007; 132: 144e15–21.
- 19Iben P, Kanellis MJ, Warren J. Appointment-keeping behavior of Medicaid-enrolled pediatric dental patients in eastern Iowa. Pediatr Dent 2000; 22: 325–9.
- 20Mirabelli JT, Huang GJ, Siu CH, King GJ, Omnell L. The effectiveness of phase I orthodontic treatment in a Medicaid population. Am J Orthod Dentofacial Orthop 2005; 127: 592–8.
- 21Horsley BP, Lindauer SJ, Shroff B, Tüfekçi E, Abubaker AO, Fowler CE et al. Appointment keeping behavior of Medicaid vs non-Medicaid orthodontic patients. Am J Orthod Dentofacial Orthop 2007; 132: 9–53.
- 22Fisher MA, Mascarenhas AK. The association between Medicaid status and broken orthodontic appointments is not clearly established. J Evid Based Dent Pract 2008; 8: 249–50.
- 23Dobbs ME, Manasse R, Kusnoto B, Costa Viana MG, Obrez A. A comparison of compliance in Medicaid versus non-Medicaid patients. Special Care. Dent 2015; 35: 56–62.
10.1111/scd.12085 Google Scholar
- 24Dickens S, Beane RA, Caplan DJ, Vann W Jr. Comparison of treatment result and compliance between private practice Medicaid and Non-Medicaid orthodontic patients–a brief communication. J Public Health Dent 2008; 68: 167–9.
- 25Nelson S, Mandelaris J, Ferretti G, Heima M, Spiekerman C, Milgrom P. School screening and parental reminders in increasing dental care for children in need: a retrospective cohort study. J Public Health Dent 2012; 72: 45–52.
- 26Mofidi M, Rozier RG, King RS. Problems with access to dental care for Medicaid-insured children: what caregivers think. Am J Public Health 2002; 92: 53–8.
- 27Christensen AA, Lugo RA, Yamashiro DK. The effect of confirmation calls on appointment-keeping behavior of patients in a children's hospital dental clinic. Pediatr Dent 2001; 23: 495–8.
- 28Almog DM, Devries JA, Borrelli JA, Kopycka-Kedzierawski DT. The reduction of broken appointment rates through an automated appointment confirmation system. J Dent Educ 2003; 7: 1016–22.
- 29Nelson TM, Berg JH, Bell JF, Leggott PJ, Seminario AL. Assessing the effectiveness of text messages as appointment reminders in a pediatric dental setting. J Am Dent Assoc 2011; 142: 397–405.
- 30Stubbs ND, Geraci SA, Stephenson PL, Jones DB, Sanders S. Methods to reduce outpatient non-attendance. Am J Med Sci 2012; 344: 211–9.
- 31Brysh LS. “Where's My Patient?”–a plan to decrease broken appointments in a predominantly Medicaid clinic. Special Care Dent 2001; 21: 126–8.
- 32Schmalzried HD, Liszak J. A model program to reduce patient failure to keep scheduled medical appointments. J Community Health 2012; 37: 715–8.
- 33Byck GR, Cooksey JA, Russinof H. Safety-net dental clinics. J Am Dent Assoc 2005; 136: 1013–21.
- 34Teich ST, Wan Z, Faddoul FF. Relationship between broken appointments and dental students' clinical experience level. J Dent Educ 2012; 76: 1167–74.
- 35Primosch RE, Balsewich CM, Thomas CW. Outcomes assessment an intervention strategy to improve parental compliance to follow-up evaluations after treatment of early childhood caries using general anesthesia in a Medicaid population. ASDC J Dent Child 2000; 68: 102–8.
- 36Harrison RL, Li J, Wyman T. The Community Dental Facilitator Project: reducing barriers to dental care. J Public Health Dent 2003; 63: 126–8.
- 37Horowitz AM, Maybury C, Kleinman DV, Radice SD, Wang MQ, Child W et al. Health literacy environmental scans of community-based dental clinics in Maryland. Am J Public Health 2014; 104: e85–93.
- 38LaGanga LR, Lawrence SR. Clinic overbooking to improve patient access and increase provider productivity. Decis Sci 2007; 38: 251–76.
- 39Gupta D, Denton B. Appointment scheduling in health care: challenges and opportunities. IIE Trans 2008; 40: 800–19.
- 40Murray M, Berwick DM. Advanced access: reducing waiting and delays in primary care. J Am Med Assoc 2003; 289: 1035–40.
- 41Kilbourne AM, Horvitz-Lennon M, Post EP, McCarthy JF, Cruz M, Welsh D et al. Oral health in Veterans Affairs patients diagnosed with serious mental illness. J Public Health Dent 2007; 67: 42–8.
- 42Clifton A, Tosh G, Khokhar W, Jones H, Wells N. Oral health advice for people with serious mental illness. Schizophr Bull 2011; 37: 464–5.
- 43Finlayson TL, Siefert K, Ismail AI, Delva J, Sohn W. Reliability and validity of brief measures of oral health-related knowledge, fatalism, and self-efficacy in mothers of African American children. Pediatr Dent 2005; 27: 422–8.
- 44Figley CR. Burnout in families: the systemic costs of caring. Boca Raton (FL): CRC Press, 1997; 240.
- 45Nielsen-Bohlman L, Panzer AM, Kindig DA. Health literacy: a prescription to end confusion. Washington, DC: National Academies Press, 2004; 345.
- 46Baur CE, Comings JP, Evans C, Garcia R, Horowitz AM, Ismail AI et al. The invisible barrier: literacy and its relationship with oral health. J Public Health Dent 2005; 65: 174–82.
- 47Vann WF, Divaris K, Gizlice Z, Baker AD, Lee JY. Caregivers' health literacy and their young children's oral-health–related expenditures. J Dent Res 2013; 92: S55–62.
- 48Lacy NL, Paulman A, Reuter MD, Lovejoy B. Why we don't come: patient perceptions on no-shows. Ann Fam Med 2004; 2: 541–5.
- 49Kvale G, Berggren U, Milgrom P. Dental fear in adults: a meta-analysis of behavioral interventions. Community Dent Oral Epidemiol 2004; 32: 250–64.
- 50De Jongh A, Adair P, Meijerink-Anderson M. Clinical management of dental anxiety: what works for whom? Int Dent J 2005; 55: 73–80.
- 51Zittel-Palamara K, Fabiano JA, Davis EL, Waldrop DP, Wysocki JA, Goldberg LJ. Improving patient retention and access to oral health care: the CARES program. J Dent Educ 2005; 69: 912–8.
- 52Klinkman MS, Bauroth S, Fedewa S, Kerber K, Kuebler J, Adman T et al. Long-term clinical outcomes of care management for chronically depressed primary care patients: a report from the depression in primary care project. Ann Fam Med 2010; 8: 387–96.
- 53Tervalon M, Murray-Garcia J. Cultural humility versus cultural competence: a critical distinction in defining physician training outcomes in multicultural education. J Health Care Poor Underserved 1998; 9: 117–25.
- 54Horowitz AM, Kleinman DV. Oral health literacy: the new imperative to better oral health. Dent Clin N Am 2008; 52: 333–44.
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