Mailed Appointment Reminders though the Composite Health Care System (CHCS): AnAnalysis of Their Cost-Effectiveness

摘要

The Military Health Care System is undergoing some drastic changes from the LeadAgent managed care plan to Capitation. With these changes in the Military Health Care System, it is becoming more important to manage the resources of both people and dollars effectively. An area that affects the productivity of a military hospital is the patient no-show rate. At the Naval Medical Center San Diego (WCSD), the patient no-show rate varies in the clinics from 3 percent to almost 20 percent of the patients seen each month. Considering that some clinics see over 2,000 patients a month, this can lead to a significant number of failed appointments. This study looked at the cost-effectiveness of mailed appointment reminders through the Composite Health Care System (CHCS). A sample of five outpatient clinics were studied during a three month period with and without the use of the automated patient mailers. A control group of five randomly selected clinics that did not use the mailers was also studied for the same time period. The results were that none of the clinics that implemented the mailers showed a statistically significant reduction in their no-show rate, P<.05. Although none displayed a statistically significant reduction, Ophthalmology did reduce their no-show rate by 3.57 percent. If a clinic had a no-show rate of 7 percent or less the rate will vary due to chance. Clinics with a no-show rate of greater than 7 percent can improve their no-show rate with the implementation on the patient mailers. The cost of a patient no-show was determined using the Medical Expense Performance Reporting System (MEPRS). The cost of a patient no-show was determined to be between $105.00 and $164.00, as compared to the cost of a mailer $0.52.