Prediction Modeling of Missed Appointments in Safety-Net Physiatry: Visit Characteristics Outperform Patient Risk Scores

Visit scheduling factors, not clinical risk scores or neighborhood vulnerability, best predict missed appointments in safety-net outpatient PM&R clinics, with a 13.1% no-show rate.

• Why it matters: Reducing missed appointments is crucial for improving care access and efficiency in safety-net settings, yet current risk assessments often rely on clinical and social data that may not be predictive.
• What they did: A retrospective cohort study analyzed 8,927 scheduled appointments, developing and validating a prediction model based on scheduling characteristics, with additional data on patient demographics and social vulnerability.
• The result: Scheduling features alone predicted no-shows with moderate accuracy (AUC ~0.66), and adding clinical or social risk scores did not improve prediction, highlighting scheduling strategies like telehealth and outreach as key intervention points.