Vision 2030 healthcare efficiency: Radiology no-shows at King Fahd Hospital of the University - Financial and...

No-shows present a global challenge in managing the resources of healthcare systems, particularly in radiology departments, where missed appointments result in machine idle time, staff underutilization, and significant loss of revenue. The objective of the study was to quantify the financial and operational burden of outpatient radiology no-shows at an academic tertiary care hospital.

In this cross-sectional study, data were retrospectively reviewed for all outpatient appointments at the Radiology Department of King Fahd Hospital of the University (KFHU) from January 1, 2024, to October 31, 2025. Data were extracted from the Hospital Information System. Financial loss was estimated by using the hospital's private services price list in Saudi Riyals (SAR), and operational burden was assessed using machine idle hours and staff underutilization hours.

During the study period, out of 76,926 overall outpatient radiological appointments, 17.9% (n = 13,743) appointments were "no-show." The "no-shows" resulted in substantial financial losses, with magnetic resonance imaging (MRI) contributing to the highest cumulative burden. Operational impact included 3.5-4 h of idle machine time and staff underutilization per missed case.

Radiology no-shows in the study represent a measurable association between missed appointments and estimated operational and financial loss at KFHU; longer appointment lead time was an important associated factor, suggesting that a reduction of booking intervals and prioritization of targeted scheduling strategies may help improve efficiency in radiology, resource utilization, and patient access.