Sociodemographic determinants of appointment no-show in primary care: a cross-sectional study in Renca Commune, Chile (2022-2023).

Abstract

BACKGROUND: Nonattendance in primary health care (PHC) is an increasing challenge for health system management, as it leads to wasted resources, greater workloads for healthcare teams, and interruptions in the continuity of care. While most studies have examined this phenomenon in the context of medical specialties, evidence from PHC settings remains scarce. This study aimed to analyze the associations between the sociodemographic and administrative characteristics of appointments at PHC centers within a large urban commune in Santiago, Chile. METHODS: A cross-sectional study was conducted using secondary data from the Rayen Salud® electronic health record system, which consolidates clinical and administrative records from the Electronic Health Records. Appointments scheduled between 2022 and 2023 were extracted, with one appointment per person randomly selected. Appointments with a status of scheduled, canceled, pending, or in progress were excluded, as were overbookings, procedures, minor surgeries, and specialty consultations. The dependent variable was appointment status (completed or not shown). Descriptive statistics and multivariate regression models were used to estimate prevalence ratios (PRs) with 95% confidence intervals (95% CIs). RESULTS: Overall, 21.8% of the appointments were not attended. Nonattendance was more common among adults aged 18–64 years (PR: 1.04; 95% CI: 1.01–1.09), patients affiliated with the public insurance system, and those scheduled via telephone or online platforms (PR: 1.41; 95% CI: 1.35–1.47). A higher prevalence was also observed on Saturdays (PR: 1.46; 95% CI: 1.33–1.59), after 17:00 h (PR: 1.20; 95% CI: 1.13–1.26), and in September (PR: 1.09; 95% CI: 1.00–1.19). With respect to professional health, general practitioners presented the lowest prevalence (PR: 0.46; 95% CI: 0.42–0.50), whereas nutritionists, dentists, and psychologists presented higher prevalence (PRs 1.32–1.82). Older adults (≥ 65 years) were more likely to attend (PR: 0.68; 95% CI: 0.64–0.71). CONCLUSIONS: No show in PHC represents a major challenge for care delivery. Targeted reminder strategies, particularly for high-risk groups, nonmedical providers, and extended-hour appointments, are essential for improving attendance and strengthening PHC performance.