Prevalence and predictors of patient no-shows to outpatient endoscopic procedures scheduled with anesthesia

BMC Gastroenterol. 2015 Sep 30:15:123. doi: 10.1186/s12876-015-0358-3.


Background: Demand for endoscopic procedures scheduled with anesthesia is increasing and no-show to appointments carries significant patient health and financial impact, yet little is known about predictors of no-show.

Methods: We performed a 16-month retrospective observational cohort study of patients scheduled for outpatient endoscopy with anesthesia at a county hospital serving the safety-net healthcare system of San Francisco. Multivariate logistic regression analysis was performed to evaluate associations between attendance and predictors of no-show.

Results: In total, 511 patients underwent endoscopy with anesthesia during the study period. Twenty-seven percent of patients failed to attend an appointment and were considered "no-show". In multivariate analysis, higher no-show rates were associated with patients with a prior history of no-show (odds ratio [OR] 6.4; 95% confidence interval [CI], 2.4- 17.5), those with active substance abuse within the past year (OR 2.2; 95% CI 1.4-3.6), those with heavy prescription opioids/benzodiazepines use (OR 1.6; 95% CI 1.0-2.6) and longer wait-times (OR 1.05; 95% CI 1.00-1.09). Inversely associated with patient no-show were active employment (OR 0.38; 95% CI 0.18-0.81), patients who attended a pre-operative appointment with an anesthesiologist (OR 0.52; CI 0.32-0.85), and those undergoing an advanced endoscopic procedure (OR 0.43; 95% CI 0.19-0.94).

Conclusion: In a safety-net healthcare population, behavioral and social determinants of health, including missed appointments, active substance abuse, homelessness, and unemployment are associated with no-shows to endoscopy with anesthesia.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Ambulatory Care / statistics & numerical data*
  • Analgesics, Opioid / therapeutic use
  • Anesthesia / statistics & numerical data*
  • Benzodiazepines / therapeutic use
  • Employment / statistics & numerical data
  • Endoscopy, Gastrointestinal / statistics & numerical data*
  • Female
  • Hospitals, County / statistics & numerical data*
  • Humans
  • Male
  • Middle Aged
  • No-Show Patients / statistics & numerical data*
  • Retrospective Studies
  • Safety-net Providers / statistics & numerical data
  • San Francisco
  • Substance-Related Disorders / epidemiology
  • Time Factors
  • Waiting Lists


  • Analgesics, Opioid
  • Benzodiazepines