Behavioural economic interventions to reduce health care appointment non-attendance: a systematic review and meta-analysis

Bibliographic Details
Title: Behavioural economic interventions to reduce health care appointment non-attendance: a systematic review and meta-analysis
Authors: Kalin Werner, Sara Abdulrahman Alsuhaibani, Reem F. Alsukait, Reem Alshehri, Christopher H. Herbst, Mohammed Alhajji, Tracy Kuo Lin
Source: BMC Health Services Research, Vol 23, Iss 1, Pp 1-13 (2023)
Publisher Information: BMC, 2023.
Publication Year: 2023
Collection: LCC:Public aspects of medicine
Subject Terms: Behavioural economics, No-show rates, Reminders, Attendance rates, Systematic reviews, Public aspects of medicine, RA1-1270
More Details: Abstract Background Appointment non-attendance – often referred to as “missed appointments”, “patient no-show”, or “did not attend (DNA)” – causes volatility in health systems around the world. Of the different approaches that can be adopted to reduce patient non-attendance, behavioural economics-oriented mechanisms (i.e., psychological, cognitive, emotional, and social factors that may impact individual decisions) are reasoned to be better suited in such contexts – where the need is to persuade, nudge, and/ or incentivize patients to honour their scheduled appointment. The aim of this systematic literature review is to identify and summarize the published evidence on the use and effectiveness of behavioural economic interventions to reduce no-shows for health care appointments. Methods We systematically searched four databases (PubMed/Medline, Embase, Scopus, and Web of Science) for published and grey literature on behavioural economic strategies to reduce no-shows for health care appointments. Eligible studies met four criteria for inclusion; they were (1) available in English, Spanish, or French, (2) assessed behavioural economics interventions, (3) objectively measured a behavioural outcome (as opposed to attitudes or preferences), and (4) used a randomized and controlled or quasi-experimental study design. Results Our initial search of the five databases identified 1,225 articles. After screening studies for inclusion criteria and assessing risk of bias, 61 studies were included in our final analysis. Data was extracted using a predefined 19-item extraction matrix. All studies assessed ambulatory or outpatient care services, although a variety of hospital departments or appointment types. The most common behaviour change intervention assessed was the use of reminders (n = 56). Results were mixed regarding the most effective methods of delivering reminders. There is significant evidence supporting the effectiveness of reminders (either by SMS, telephone, or mail) across various settings. However, there is a lack of evidence regarding alternative interventions and efforts to address other heuristics, leaving a majority of behavioural economic approaches unused and unassessed. Conclusion The studies in our review reflect a lack of diversity in intervention approaches but point to the effectiveness of reminder systems in reducing no-show rates across a variety of medical departments. We recommend future studies to test alternative behavioural economic interventions that have not been used, tested, and/or published before.
Document Type: article
File Description: electronic resource
Language: English
ISSN: 1472-6963
Relation: https://doaj.org/toc/1472-6963
DOI: 10.1186/s12913-023-10059-9
Access URL: https://doaj.org/article/0e86b97ed0e7434c812b16724cc9d9ac
Accession Number: edsdoj.0e86b97ed0e7434c812b16724cc9d9ac
Database: Directory of Open Access Journals
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More Details
ISSN:14726963
DOI:10.1186/s12913-023-10059-9
Published in:BMC Health Services Research
Language:English