Charging for missed appointments.

Abstract

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The argument for and against the imposition of fines. Recent studies show that patient non-attendance rates vary between 5% and 25%. Norway has a universal, tax-financed healthcare system and a standard non-attendance fee (currently €139) has been applied since 2009. Since 2009, the Norwegian government has instigated five public consultations on non-attendance fees in healthcare. Reviewing comments from these consultations, it appears that such fees are broadly supported and accepted by the public. However, a number of objections were identified: • There is little evidence that such fees are effective and do not act as a motivational tool -there may be other reasons for non-attendance, such as unforeseen personal crises • In line with other studies, fees were considered resource-demanding to implement • Socially vulnerable groups, with an increased risk of poor health, are likely to be unequally disadvantaged by non-attendance fees • Due to the additional income, there is a perverse incentive for providers not to seek alternatives strategies to reduce non-attendance.