Reasons for Non-Attendance at Health Service Appointments and Strategies to Address: A Literature Review

Ms Kathryn Bailey1, Dr Kathleen Ryan1

1St Vincent’s Hospital Melbourne, Fitzory, Australia


Aim: To understand the reasons for non-attendance (cancellations / Did Not Arrive (DNA))of outpatient health appointments and identify effective strategies.

Method: Undertake a literature review of reasons for non attendance at health outpatient appointments and strategies to address.

Results: Key reasons for non-attendance included illness, forgetting (Odonkor, et al., 2017, family commitments (Neal, et al., 2005), confusion (Guedes, et al., 2013), personal life circumstances, transport problems, money, mental health and stress (Pieper, et al., 1998).

Non attendance is higher in patients with Culturally And Linguistically Diverse (C.A.L.D.) backgrounds (Torres, et al., 2015) and younger people (Feitsma, et al., 2012).

Follow up appointments have higher non-attendance rates especially if a delay between making and having the appointment (McMullen, et al., 2015). A strong predictor of non-attendance is previous cancellation (Soendergaard, 2016).

How providers respond to no-shows (Kwintner 2011) is also a key factor.

Strategies to decrease non attendance included reminders (phone, mail, text) especially if there is a delay between making and attending the appointment (Quinn, 2007). Clinician reminders are more effective than automated messages (Parikh 2010).

Establishing obstacles to accessing care and addressing these (Luckett, et al., 2015) and identifying those who routinely miss appointments (Hills, 2009) and clinicians responding quickly and assertively to these  (Shapiro, 2015) are helpful.

Significance of findings to allied health: Implement evidenced based strategies to decrease non attendance of outpatient appointments and increase utilisation of limited allied health resources.


Kathryn Bailey is the Manager of St Vincent’s Hospital Melbourne Health Independence Program Rehabilitation and Specialist Clinics including Community Rehabilitation Centers, Continence, Falls and Memory clinics.