The objective of this study was to identify factors that contributed to missed appointments in an inner city practice and devise and implement intervention and assess its effects. The study involved 294 children under 5 years of age who had appointments to the primary care practice at Kings County Hospital during a 3 month period (May-July, 1994). Fifty three children (18%) missed appointments. We were able to contact by telephone 41 of 53 care takers and 25 (61%) cited failure to remember as the reason for missing appointments. Other reasons such as attendance to other clinics, change of health insurance, working parent, new baby, etc., were given by individual respondents. Our intervention strategy was to send a letter 14 days before the appointment followed by telephone call a week later. During the follow up period the no-show rate was significantly reduced to 9%.

Failure to remember the date of appointment appears to be the major cause of missed appointment and reminders offers a simple and inexpensive strategy.