PREDICTORS OF FAILURE TO ATTEND SCHEDULED MAMMOGRAPHY APPOINTMENTS ATA PUBLIC TEACHING HOSPITAL

Objective: To identify patient, institutional, and physician character istics that predict failure to attend scheduled mammography appointmen ts. Design: Retrospective chart review. Setting: Medicine clinic at an urban public teaching hospital. Patients: All 907 women aged 40 years and more scheduled for mammography from March 1990 to June 199 1. Mea surements and main results: The main outcome measure was whether a wom an kept her scheduled mammography appointment. Potential predictor var iables included patient age, race, marital status, and insurance statu s; waiting interval to obtain a mammography appointment; and physician gender, level of training, country of training, and native language. The rate of failed mammography appointments was 23%. Univariate analys is showed that appointment failure was associated with age (p = 0.03), with the lowest failure rates (1 9%) among women aged 60 years and mo re. Appointment keeping varied significantly by race (p = 0.0 1), larg ely because of the higher failure rate among Native American women (36 %). Insured women had a failure rate of 22% vs 33% for uninsured women (p = 0.0 1). The rate of failed appointments varied significantly by waiting interval (p = 0.05), with a peak failure rate of 27% for appoi ntments scheduled 14 - 27 days in advance. None of the physician varia bles was associated with appointment failure. Multivariate analysis co nfirmed these results. Conclusions: Interventions to improve completio n of breast cancer screening should include additional efforts targete d at groups with high rates of appointment failure, such as women unde r the age of 60, the uninsured, and Native Americans. Long waiting int ervals to obtain mammography appointments may decrease compliance.