In this guide
Why measure retention
Getting a new patient through the door costs marketing, reputation and time. Keeping a patient who already trusts you costs a reminder and a follow-up. Yet most facilities can tell you yesterday's collections and cannot tell you how many of last month's patients came back. You cannot manage a leak you never measure.
The six numbers
| Number | Formula | What it tells you |
|---|---|---|
| Returning patient rate | First-time patients from 90 days ago who returned at least once, divided by all first-time patients in that month | Whether your care and follow-up earn a second visit |
| No-show rate | Booked appointments not attended, divided by all booked appointments | How many paid-for slots go empty |
| ANC completion rate | Mothers who delivered this month and completed the contacts due for their gestation, divided by all mothers who delivered | Whether mothers stay on the antenatal schedule |
| Immunisation on-time rate | Vaccine doses given within the due window, divided by doses due | Whether babies stay on the KEPI schedule |
| PNC follow-up reach | Mothers reached for postnatal follow-up, divided by mothers who delivered | Whether care continues after delivery |
| Patients slipping away | Count of patients with a follow-up due who have not returned in 60 or more days | A named list your team can act on this week |
Calculating them from your register
You do not need software to start. From your register or a simple spreadsheet you need four columns per visit: patient ID, visit date, whether it was a first visit, and the next appointment date if one was booked. With those:
- Filter first visits for a month three months ago, then check which of those IDs appear again later. That gives you the returning patient rate.
- Count next-appointment dates that fell in the last month, then check how many of those patients actually came. The difference is your no-show rate.
- Sort by last visit date. Anyone with a booked follow-up that is more than 60 days in the past goes on the slipping-away list.
A worked example
These are illustrative numbers, not results from a real facility. Picture a clinic that saw 200 first-time patients in June. By the end of September, 76 of them had come back at least once.
Returning patient rate = 76 / 200 = 38%. If the clinic lifts that to 45%, the same 200 first visits produce 14 more returning patients, every month, without spending anything on marketing.
Run the same arithmetic with your own numbers and your own average visit value. For most facilities, one extra returning patient a week pays for a follow-up system many times over.
A 30-minute monthly routine
- Calculate the six numbers on the first working day of the month.
- Compare each with last month. Circle anything that moved by more than five points.
- Hand the slipping-away list to a named person with a deadline.
- Pick one fix for the month, for example two reminders instead of one, or calling defaulters on Fridays.
- Check next month whether the number moved.
HealthBridge sends facility owners these six numbers every month in plain language, with no dashboards to learn. You can see exactly what that report looks like below.
See the report owners receive every month
A real sample of the monthly retention report: returning patients, no-shows, ANC completion, immunisations and the patients slipping away. Fictional facility, real format. Free, no follow-up calls.