Abstract：
OBJECTIVE: Missed appointments within the National Health Service (NHS) are a drain on resources, associated with not only considerable time and cost implications, but also sub-optimal health outcomes. This literature review aims to explore non-attendance within the NHS in relation to causes, impacts and possible mitigation of negative effects of missed appointments.
METHODS: MEDLINE, CINAHL Plus and PubMed were searched with a date range of 2016-2021. Databases were searched for peer-reviewed articles published in English addressing non-attendance of adults within the NHS. Studies were excluded if they were theoretical papers, dissertations or research concerning patients aged under 18. A total of 21 articles met the inclusion criteria and were selected for analysis.
RESULTS: The results indicate a significant association of non-attendance and poor health outcomes. Patients from a lower socioeconomic status, adults aged over 85 and those with multiple co-morbidities are more likely to miss appointments. The most commonly reported patient-centred reasons for failing to attend were forgetfulness, transportation difficulties, and family commitments. Practice-specific reasons were cited as inefficiencies of the appointment booking system, failure of traditional reminders and inconvenient timings. Interventions included text reminder services, the inclusion of costs within reminders and enhanced patient involvement with the booking process.
CONCLUSIONS: Non-attendance is complex, and to secure maximum attendance, targeted interventions are required by healthcare facilities to ensure patient needs are met. The adaption of scheduling systems and healthcare services can assist in reducing DNA rates.
METHODS: MEDLINE, CINAHL Plus and PubMed were searched with a date range of 2016-2021. Databases were searched for peer-reviewed articles published in English addressing non-attendance of adults within the NHS. Studies were excluded if they were theoretical papers, dissertations or research concerning patients aged under 18. A total of 21 articles met the inclusion criteria and were selected for analysis.
RESULTS: The results indicate a significant association of non-attendance and poor health outcomes. Patients from a lower socioeconomic status, adults aged over 85 and those with multiple co-morbidities are more likely to miss appointments. The most commonly reported patient-centred reasons for failing to attend were forgetfulness, transportation difficulties, and family commitments. Practice-specific reasons were cited as inefficiencies of the appointment booking system, failure of traditional reminders and inconvenient timings. Interventions included text reminder services, the inclusion of costs within reminders and enhanced patient involvement with the booking process.
CONCLUSIONS: Non-attendance is complex, and to secure maximum attendance, targeted interventions are required by healthcare facilities to ensure patient needs are met. The adaption of scheduling systems and healthcare services can assist in reducing DNA rates.
摘要：
目的：国家卫生服务（NHS）内的错过任命是对资源的消耗，不仅涉及相当大的时间和成本，但也是次优的健康结果。这篇文献综述旨在探讨NHS内不出勤的原因，影响和可能减轻错过约会的负面影响。
方法：MEDLINE，搜索CINAHLPlus和PubMed，日期范围为2016-2021年。在数据库中搜索了以英文发表的同行评审文章，这些文章涉及NHS中成年人的不出勤。如果是理论论文，研究被排除在外，关于18岁以下患者的论文或研究。共有21篇文章符合纳入标准，并进行分析。
结果：结果表明未就诊和不良健康结果之间存在显著关联。社会经济地位较低的患者，85岁以上的成年人和患有多种合并症的人更有可能错过约会。最常见的以患者为中心的未能参加的原因是健忘，交通困难,和家庭承诺。具体实践的原因被认为是预约系统效率低下，传统提醒的失败和不方便的计时。干预措施包括短信提醒服务，将费用纳入提醒中，并加强患者对预订过程的参与。
结论：不出勤是复杂的，为了确保最大的出勤率，医疗机构需要有针对性的干预措施,以确保满足患者的需求.调度系统和医疗保健服务的适应可以帮助降低DNA比率。
方法：MEDLINE，搜索CINAHLPlus和PubMed，日期范围为2016-2021年。在数据库中搜索了以英文发表的同行评审文章，这些文章涉及NHS中成年人的不出勤。如果是理论论文，研究被排除在外，关于18岁以下患者的论文或研究。共有21篇文章符合纳入标准，并进行分析。
结果：结果表明未就诊和不良健康结果之间存在显著关联。社会经济地位较低的患者，85岁以上的成年人和患有多种合并症的人更有可能错过约会。最常见的以患者为中心的未能参加的原因是健忘，交通困难,和家庭承诺。具体实践的原因被认为是预约系统效率低下，传统提醒的失败和不方便的计时。干预措施包括短信提醒服务，将费用纳入提醒中，并加强患者对预订过程的参与。
结论：不出勤是复杂的，为了确保最大的出勤率，医疗机构需要有针对性的干预措施,以确保满足患者的需求.调度系统和医疗保健服务的适应可以帮助降低DNA比率。
