Prevalence, predictors and economic consequences of no-shows

Parviz Kheirkhah, Qianmei Feng, Lauren M Travis, Shahriar Tavakoli-Tabasi, Amir Sharafkhaneh, Parviz Kheirkhah, Qianmei Feng, Lauren M Travis, Shahriar Tavakoli-Tabasi, Amir Sharafkhaneh

Abstract

Background: Patients 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.

Method: This 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.

Results: The 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.

Conclusions: Our 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.

Figures

Fig. 1
Fig. 1
No-show rate for 10 main clinics in different VA hospitals at VISN16 in 2008
Fig. 2
Fig. 2
No-show rate in each day for 10 main clinics in VA hospital at Houston in 2008
Fig. 3
Fig. 3
No-show rate in each month for 10 main clinics in VA hospital at Houston (2008)
Fig. 4
Fig. 4
No-show rates in 10 main clinics in VA hospital at Houston
Fig. 5
Fig. 5
No-show rate in 10 main clinics before and after applying new phone system

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Source: PubMed

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