A - 66 Factors Impacting Appointment No-Shows and Cancellations in Neuropsychology: Predictors for Improving Access to Care for a Diverse Patient Population

Abstract Objective Access to care can be impacted adversely by appointment adherence. We aimed to identify predictors of no-shows and cancellations for neuropsychological services offered by a healthcare system serving diverse communities. Method Demographics and appointment status were documented from a sample of 537 consecutive patients scheduled for neuropsychological evaluation at an outpatient psychiatry clinic. Patients included 220 males and 317 females with an average formal education of 11.01 years (SD = 3.87) and age of 55.64 years (SD = 16.2). Chi-square analyses were used to evaluate the association between appointment status and gender, race/ethnicity, payor, availability of a collateral, and MyChart access. Multivariate analysis of variance was used to assess the relationship between age, education, proxy income, and prior no-show rate with appointment status. Results The overall rate of no-shows or late cancellations was 20%, and some patients no-showed multiple times. No-shows and late cancellations were associated with historical no-show rates and older age (F = 14.60, p < 0.0001), while race/ethnicity and MyChart activation had slight impacts (χ2 = 5.572, p = 0.062 and χ2 = 3.69, p = 0.055, respectively). Being a monolingual Spanish speaker was associated negatively with MyChart activation, but positively with collateral availability (p < 0.05). Conclusions No-show rates, which impact access to care, are high and associated with prior history of no-shows. Other factors, such as MyChart activation and culturally-associated barriers may also impact access. Implementing interventions addressing prior no-show rates and enhancing MyChart access could significantly increase show rates; such improvements could increase patient access to care, reduce the system’s financial burden, and decrease wait times for other patients.