Auckland District Health Board sick of $17m no-shows

By ANNE BESTON

Patients who miss appointments are costing Auckland District Health Board $17 million a year, and it has decided to do something about it.

A system being introduced over the next few months will require those with appointments to see a specialist for everything from cataracts to menstrual problems to confirm their attendance or miss out.

Outpatient clinic spokesman Dr Allan Pelkowitz said every missed appointment cost the health board $350.

"This is not a hospital problem, it's a community problem because it's so costly," he said.

People would be given every chance to attend, he said, including being reminded by phone or even a visit from hospital staff.

The worst-attended clinics within the board's services have a no-show rate of up to 30 per cent. Across all services, the rate is estimated at about 12 per cent, but Dr Pelkowitz believes that figure does not reflect the true rate because record-keeping is inconsistent.

Board chairman Wayne Brown said missed appointments were a waste of precious funds.

"For every person who doesn't turn up, there's someone left sitting on a waiting list who's missing out."

Dr Pelkowitz said patients could ring a call centre or the hospital and confirm attendance.

"So really what we're saying is if people don't phone us, they won't get the appointment. It all fits in with people feeling they have some responsibility."

He said the Counties-Manukau District Health Board had put in a similar system and managed to cut absenteeism at some clinics from about 26 per cent to 5 per cent.

At the end of last year, the Auckland board did its own research on 130 outpatients who did not show up.

More than a third did not respond because of incorrect addresses, but of the two-thirds who did, half had got better, forgotten or had the procedure done elsewhere.

Only two failed to show up because of an emergency on the day, such as lack of childcare or sudden illness.

The board is responsible for Auckland, Green Lane, National Women's and Starship hospitals as well as dozens of departments and clinics that book about 400,000 outpatient appointments a year.

The missed-appointment rate in Auckland compares with about 14 per cent in Britain and 13-26 per cent in the US.

Research done in Britain on non-attendance found that 62 per cent of missed appointments could be blamed on patient apathy.

Missed appointments were estimated to cost the National Health Service about $750 million a year.

nzherald.co.nz/hospitals