Prevalence, predictors and economic consequences of no-shows

BMC Health Serv Res. 2016 Jan 14:16:13. doi: 10.1186/s12913-015-1243-z.


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.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Aged
  • Ambulatory Care Facilities / economics
  • Ambulatory Care Facilities / statistics & numerical data*
  • Appointments and Schedules
  • Costs and Cost Analysis
  • Delivery of Health Care / economics
  • Female
  • Health Resources / economics
  • Hospitals, District / economics
  • Hospitals, District / statistics & numerical data
  • Humans
  • No-Show Patients / economics
  • No-Show Patients / statistics & numerical data*
  • Primary Health Care / economics
  • Reminder Systems / economics
  • Reminder Systems / statistics & numerical data
  • Retrospective Studies
  • Texas