Abstract
BackgroundPatients not attending to clinic appointments (no-show) significantly affects delivery, cost of care and resource planning. We aimed to evaluate the prevalence, predictors and economic consequences of patient no-shows.MethodThis is a retrospective cohort study using administrative databases for fiscal years 1997–2008. We searched administrative databases for no-show frequency and cost at a large medical center. In addition, we estimated no-show rates and costs in another 10 regional hospitals. We studied no-show rates in primary care and various subspecialty settings over a 12-year period, the monthly and seasonal trends of no-shows, the effects of implementing a reminder system and the economic effects of missed appointments.ResultsThe mean no-show rate was 18.8 % (2.4 %) in 10 main clinics with highest occurring in subspecialist clinics. No-show rate in the women clinic was higher and the no-show rate in geriatric clinic was lower compared to general primary care clinic (PCP). The no-show rate remained at a high level despite its reduction by a centralized phone reminder (from 16.3 % down to 15.8 %). The average cost of no-show per patient was $196 in 2008.ConclusionsOur data indicates that no-show imposed a major burden on this health care system. Further, implementation of a reminder system only modestly reduced the no-show rate.
Highlights
Patients not attending to clinic appointments significantly affects delivery, cost of care and resource planning
No-show rate in the women clinic was higher and the no-show rate in geriatric clinic was lower compared to general primary care clinic (PCP)
A Missed appointment (MA) was the categorization assigned where a patient did not come to the appointment
Summary
Patients not attending to clinic appointments (no-show) significantly affects delivery, cost of care and resource planning. In a community hospital setting, Clark [2] reported an average no-show rate of 62 appointments per day and an estimated annual cost of $3 million. In a training hospital setting, Xakellis and Bennett [3] reported a 25 % no-show rate and a 31 % late arrival to appointments. Moore and colleagues [4] found that no-shows and Providers use different methods to reduce the patient no-show, including reminder procedures, penalization, and overbooking. Satiani and colleagues [13] reported that automated reminder systems did not significantly reduce the no-show rate. Hixon and colleague [14] found no difference in no-show rates when clinics use reminder systems to reduce no-show
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