BMJ 1999;318:1392-1395 ( 22 May )

General Practice

Effect on hospital attendance rates of giving patients a copy of their referral letter: randomised controlled trial

William Hamilton, general practitioner, ^a Alison Round, consultant in public health medicine, ^b Deborah Sharp, professor. ^c

^a 12 Barnfield Hill, Exeter EX1 1SR, ^b North and East Devon Health Authority, Dean Clarke House, Southernhay East, Exeter EX1 1PQ, ^c Division of Primary Health Care, University of Bristol, Canynge Hall, Bristol BS8 2PR

Correspondence to: Dr Hamilton barnfield.hill.research{at}which.net

Objectives: To investigate whether sending patients a copy of their referral letter can reduce non-attendance at outpatient departments.
Design: Blinded randomised controlled trial.
Setting: 13 general practices in Exeter, Devon.
Subjects: 2078 new consultant referrals from 26 doctors.
Main outcome measures: Non-attendance at outpatient departments.
Results: The doctors excluded 117 (5.6%) referrals, and 100 (4.8%) received no appointment. Attendance data were available for 1857 of the 1861 patients sent an appointment (99.8%). The receipt of a copy letter had no effect on the non-attendance rate: copy 50/912 (5.5%) versus control 50/945 (5.3%).
Conclusion: Copy letters are ineffective in reducing non-attendance at outpatient departments.

Key messages Copy letters to the patient do not decrease non-attendance at hospital outpatients The concept of copying letters to patients is acceptable to doctors and patients It may be possible to apply interventions from primary care to reduce non-attendance

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Non-attendance at out patients

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bmj.com, 26 May 1999 [Full text]

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