Impact of Automated Calls on Pediatric Patient Attendance in Chile (Health Call)

Health Call: A Randomized Control Trial of Interactive Automated Reminder Calls to Reduce Failure to Attend Rates at an Urban Referral Hospital in Chile

Missed health care appointments present a serious challenge to patient care. Especially in government funded health systems like that of Chile, missed appointments can lead to delayed care, wasted resources, and escalating costs.

This private-public-research collaboration seeks to provide a rigorous, practical evaluation of a new patient reminder system, evaluate how health beliefs impact patient attendance, and capture the potential for scaling up this or other health technology systems. Using a mixed-methods approach this study will provide contextualized, triangulated analysis of pediatric patient attendance in Chile.

Study Overview

• Status: Completed
• Conditions: Attendance
• Intervention / Treatment: Behavioral: Health Call

Detailed Description

The Health Call study is divided into two phases. The first phase is a randomized controlled trial and side-by- side cost-benefit analysis. Enrolled guardians of pediatric patients will complete a questionnaire at the point of referral and then be randomized to intervention, the automated reminder system, or no reminder. The investigators will then monitor attendance status at their subsequent appointment and evaluate whether the appointment reminders affected attendance as well as the cost-benefit ratio of using the reminder system.

The second phase will involve interviewing guardians and healthcare professionals. These interviews have two foci. First, combined with patient, guardian, and/or household data from the randomized trial, these results will be used to develop a more comprehensive understanding of why pediatric patients attend appointments. The second focus is on improving the reminder system and developing new health technology interventions that can increase patient attendance.

• Study Type: Interventional
• Enrollment (Actual): 263
• Phase: Not Applicable

Contacts and Locations

Study Locations

• Chile
  • Santiago, Chile
    • Hospital Luis Calvo Mackenna

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: No older than 18 years (Child, Adult)
• Accepts Healthy Volunteers: Yes
• Genders Eligible for Study: All

Description

Inclusion Criteria:

• Guardian with a phone number (land-line or mobile) who is able to receive and answer voice calls
• Guardian who is willing to take part in the study and complete the consent form
• Guardian who is sufficiently proficient in Spanish so as to complete the questionnaire
• Guardian's patient who has a referral appointment at Hospital Luis Calvo Mackenna who is 18 years of age or younger

Exclusion Criteria:

• Guardian or child who do not meet the inclusion criteria
• Anyone that lives in the same household as an enrolled study participant.

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Health Services Research
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: Single

Number of Arms

2

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
No Intervention: No Intervention; The intervention arm subjects will not receive the automated interactive voice reminder before their appointment.
Experimental: Intervention; The intervention arm subjects will receive the automated interactive voice reminder before their appointment.	Behavioral: Health Call; Health Call is an automated interactive voice reminder system that can contact guardians of patients ahead of their child's appointment, asks then confirms a security question about the patient, then, if the call recipient passes the security screen, provides a reminder about upcoming appointment.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Intervention impact	Evaluate whether a patient reminder system, Health Call, can decrease the overall failure to attend appointment rate as a percentage of overall appointments	9 months
Key attendance factors	Examine what demographic or health belief factors are significantly related to appointment attendance as measured by a psychometric questionnaire	9 months
Develop new interventions	Investigate staff and recipient opinions of patient attendance, the Health Call system, and ideas for future interventions to reduce failure to attend as measured through in-depth interviews	9 months

Collaborators and Investigators

• Sponsor: Johns Hopkins Bloomberg School of Public Health
• Collaborators: Hospital Luis Calvo Mackenna; Merlin Telecom
• Investigators: Principal Investigator: William Weiss, DrPH, MA, Johns Hopkins Bloomberg School of Public Health

Study record dates

Study Major Dates

• Study Start: December 1, 2013
• Primary Completion (Actual): January 1, 2016
• Study Completion (Actual): June 1, 2016

Study Registration Dates

• First Submitted: April 6, 2015
• First Submitted That Met QC Criteria: May 8, 2015
• First Posted (Estimate): May 13, 2015

Study Record Updates

• Last Update Posted (Estimate): June 14, 2016
• Last Update Submitted That Met QC Criteria: June 10, 2016
• Last Verified: May 1, 2015

More Information

Terms related to this study

• Keywords: Randomized controlled trial; mHealth; eHealth; Global Health; Integrated Health Care Systems; Chile; Health Technology; Health Systems; Health Information Systems; Referral and Consultation; Non-attendance; No Show; Efficiency, Organizational; Pediatric Hospitals; Health Care Systems; Community Health Systems; Community Medicine
• Other Study ID Numbers: 00004109