Factors associated with non-attendance at a hand surgery appointment

Patients who miss scheduled appointments without notifying office staff--"no-shows"--disrupt practice workflow and decrease access for others, resulting in misuse of resources and lost revenue. The primary purpose of this study was to identify factors associated with no-shows in a hospital-based outpatient hand office. Secondarily, we studied factors associated with cancelations.

Of the 14,793 new adult patient appointments to our outpatient hand surgery office scheduled between January 2011 and December 2013, 880 (5.9 %) were no-shows and 2715 (18 %) were cancelations. Data on patient demographics and timing of the visit were collected to construct a multinomial logistic regression model of determinants of appointment no-shows and cancelations.

Factors independently associated with no-shows included younger age, Hispanic or black race, unmarried status (single or divorced), appointment on a Monday or Tuesday, and residence near the office. Factors associated with cancelations were female sex, unmarried status (widowed or divorced), winter season, and appointment on a weekday other than Friday.

Non-attendees are more likely to be younger, unmarried, non-white, to have their appointments at the start of the week, and to live near the office. Knowledge of these factors might prove useful for implementation of tailored quality improvement initiatives to reduce non-attendance and maximize productivity in the hand surgery office setting.

Prognostic IV.