Missed Monday Appointments

To the Editor: In a brief report in the March issue, Dr. Gallucci and his colleagues (1) reported on the impact of waiting time until appointment on the rate of attendance at the first appointment in an outpatient psychiatric setting. They found that delay had a significant impact on attendance, especially during the first week—each day of delay negatively affected the attendance rate. This result is intuitively and clinically appealing.

We suggest that the authors might further analyze their data. We conducted a one-month survey in four outpatient facilities in Geneva, Switzerland, taking into account not only initial appointments but also follow-up ones (2). The overall rate of missed appointments was 8.1 percent (177 of 2,177 scheduled appointments). We found that delay is probably not the only time-related relevant factor. In our study, comparison of proportions of missed appointments indicated a trend (p<.052) for differences across days, with the highest proportion on Mondays (12.6 percent) and the lowest proportion on Wednesdays (6.5 percent). To our knowledge, this aspect has not yet been addressed in the literature. We hypothesize that similar differences might be observed in other behaviours, such as absenteeism at work.

We fully agree with Dr. Gallucci and his colleagues that a better understanding of the motives for missed appointments will contribute to preserving staff and financial resources.

The authors are affiliated with the department of psychiatry at Geneva University Hospitals.