ackground: High no-show rates and limited follow-up care hinder chronic disease management in underserved populations. Telehealth has emerged as a potential solution to enhance care continuity, yet its effectiveness in reducing missed appointments and improving patient engagement remains underexplored.
Purpose: This study evaluated the impact of a telehealth program at a community clinic in Koreatown, Los Angeles, serving Medicaid and uninsured patients on show/no-show rate. The primary objectives were to: a) compare the difference in show/no show rates between telehealth and in-person-visits, b) determine if there are associations between show/no-show rates and demographic variables, c) determine if there are associations between patient satisfaction and the type of visit (mixed visit VS in-person visit).
Methods: An observational design was used to analyze no-show rates from the clinic’s scheduling system in 2024. Patient satisfaction was assessed through surveys conducted between September and December 2024. Statistical analyses, including logistic and linear regression models, were performed to evaluate appointment attendance and satisfaction predictors.
Results: Telehealth visits had significantly lower no-show rates (1.25%) compared to in-person visits (9.63%) (OR = 8.230, p < .001). Age was a positive predictor of attendance (p < .004), while African American patients had a 55.1% lower likelihood of attending compared to Hispanic patients (p = .009). Survey results indicated high satisfaction with telehealth (92.5%), particularly among those who had both telehealth and in-person visits. Effective provider communication (p < .001) and ease of scheduling (p < .001) were the most significant predictors of patient satisfaction. Barriers to telehealth included technology access (5%), internet connectivity issues (19%), and a preference for face-to-face interactions (6.7%).
Conclusion: Telehealth significantly improves follow-up adherence, reduces no-show rates, and enhances patient satisfaction, particularly when combined with in-person visits. A hybrid model integrating telehealth for follow-ups and chronic disease management while reserving in-person visits for complex cases is recommended. Addressing technological barriers, expanding language support, and enhancing digital literacy programs can further optimize healthcare access and outcomes.