Factors Contributing to Late Cancellation and No-Show for Otolaryngologic Surgery: A Prospective Study

Abstract

Purpose:Late cancellations and no-shows for surgery place a burden on patients, healthcare providers, and the health system. We aim to identify risk factors contributing to this phenomenon.Methods:Patients who did not arrive for, or canceled within 24 hours of, their surgical appointment between January 2019 and 2020 were identified. Controls were matched by date, procedure, and gender. Demographic information was obtained by phone interview and chart review. Chi-square and Student t-test analyses were used to predict risk factors for cancellation.Results:Thirty-one patients were identified, of whom 21 completed phone interviews. Age, gender, race, language, marital status, and smoking status were not significantly different. Study patients reported more transportation challenges (33.3% vs. 4.8%, p = .01) yet lived closer to the hospital (4.53 miles vs. 14.05 miles, p = .01). Study patients lived in lower income zip codes ($48,145 vs. $63,406, p = .02) and more commonly had Medicaid as their primary insurance (70.9% vs. 38.7%, p = .04). Most commonly, no reason was given for cancellation (22.6%) followed by personal reasons (16.1%) and surgery reconsideration (16.1%).Conclusions:Transportation trouble and lower income are significant risk factors for surgery late cancellation. Prior no-show must also be considered. A targeted pilot program may help prevent late cancellations.

Personal, health system, and geosocial disparities in appointment nonadherence at family medicine clinics in southcentral Pennsylvania, United States

“…Yet, more than 15%–30% of patents missed their appointments, 4 potentially costing the U.S. health systems over $150 billion dollars 4 . There have also been concerns regarding an increased number of late cancellations which can disrupt the continuity of care for patients and interrupt clinical workflows for medical practices 5 . The COVID‐19 pandemic has further exacerbated missed appointment rates, as the pandemic‐related anxiety and uncertainty increase 6 .…”

“… 4 There have also been concerns regarding an increased number of late cancellations which can disrupt the continuity of care for patients and interrupt clinical workflows for medical practices. 5 The COVID‐19 pandemic has further exacerbated missed appointment rates, as the pandemic‐related anxiety and uncertainty increase. 6 Despite great efforts in maintaining care continuum by building patient–provider relationships and offering more access options, many health systems continue to struggle with patients missing their appointments.…”