No-Shows Trended Upward When Psychiatric Clinic Solely Offered Telehealth

One month after an outpatient psychiatric clinic in West Texas transitioned to 100% telepsychiatry services in March 2020, no-show appointments spiked, according to a poster presented at the virtual 2021 American Psychiatric Association Annual Meeting.

“The COVID-19 pandemic prompted a national waiver expanding telehealth,” wrote first author Nancy D. Madia, MD, and colleagues from Texas Tech University Health Sciences Center, Odessa, Texas. “However, despite telehealth’s proven quality and effectiveness, its impact on patient compliance remains in question. As medical associations call for an extension of the waiver authority, it is essential to evaluate telehealth’s impact on missed appointments.”

The study looked at the percentage of appointments that were no-shows between March 2019 and July 2020.

Patients Cite Illness, Transportation as Barriers Eliminated By Telehealth

Rates of no-show appointments ranged between 10% and 11.8% from October 2019 through January 2020, according to the poster. Rates dipped to 8.3% in February 2020. In March 2020, no-shows accounted for 12.4% of appointments and then increased significantly to 21.4% in April 2020, by which time the clinic had transitioned to 100% telehealth. No-shows accounted for 14.1% of appointments in both May 2020 and June 2020 and 13.8% in July 2020.

“There was a significant upward trend in no-show appointments after telehealth was implemented,” researchers wrote. “Since then, the no-show rate has decreased but remains higher than pre-telehealth months.”

When researchers considered no-shows by age group, they found similar upward trends for patients age 19 years and younger, patients age 40 to 59, and patients age 60 to 79. Patients age 20 to 39 showed an upward spike in April 2020 but no such trend afterward. Patients age 80 and older showed an upward trend in no-shows but the sample size was underpowered to detect a significant difference, according to the poster.

“Although telehealth offers a myriad of benefits for psychiatric care, factors that may impact appointment compliance should be further examined in order to guarantee equal access among all patients,” researchers advised.

—Jolynn Tumolo