Predictors of No-show Rate in the GI Endoscopy Suite at a Safety Net Academic Medical Center

Asim Shuja, Ciel Harris, Petra Aldridge, Miguel Malespin, Silvio del Melo

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background/Objectives: Noncompliance with physician and procedure appointments is associated with poor disease control and worse disease outcomes. This also impacts the quality of care, decreases efficiency, and affects revenue. Studies have shown that no-show rates are higher in clinics caring for underserved populations and may contribute to poorer health outcomes in this group. Methods: We performed a 17-month retrospective observational cohort study of patients scheduled for outpatient procedures in the Gastroenterology endoscopy suite at the University of Florida Health, Jacksonville. Multivariate logistic regression analysis was performed to evaluate associations between attendance and predictors of no-show. Results: In total, 6157 patients were scheduled to undergo different GI procedures during the study period. A total of 4388 (71%) patients completed their procedure, whereas 2349 (29%) failed to attend their appointment and were considered "no-show". There was a significant relationship between the visit attendance and race, insurance, gender, and marital status. Males had a higher no-show rate compared with females (30% vs. 28%; P<0.05). African Americans had the highest no-show rate (32%; P<0.05) amongst different races. Patients scheduled for surveillance colonoscopy (ie, history of polyps, IBD, Colon cancer) were more likely to show (78%) than those obtaining initial colorectal cancer screening (74%) or other indications (71%) (P<0.05). In the logistic regression model, patients with commercial insurance are more likely to show for their appointments than those with noncommercial insurance (eg, Medicare, Medicaid, City contract etc) [odds ratio (OR), 2.6; 95% confidence interval (CI), 2.2-3.0]. The odds of showing up are 1.7 times higher for married men compared with single men (OR, 1.7; 95% CI, 1.3-2.0). Similarly, married females are more likely to show up for appointment than single females (OR, 1.1; 95% CI, 0.9-1.3). We did not find significant association between the type of GI procedure (eg, colonoscopy vs. esophagogastroduodenoscopy vs. advanced endoscopic procedures) (P>0.05). Conclusions: Predictors of no-shows for endoscopic gastrointestinal procedures included unpartnered or single patients, African American race and noncommercial insurance providers. Patients scheduled for surveillance colonoscopy had better adherence than initial screening. Further studies are required to better characterize these factors and improve adherence to the outpatient appointments based on the identified predictors.

Original languageEnglish (US)
Pages (from-to)29-33
Number of pages5
JournalJournal of Clinical Gastroenterology
Volume53
Issue number1
DOIs
StatePublished - Jan 1 2019
Externally publishedYes

Fingerprint

Endoscopy
Safety
Appointments and Schedules
Outpatients
Insurance Coverage
Quality of Health Care
Health
Marital Status
Vulnerable Populations
Gastroenterology
Colonoscopy
Insurance
African Americans
Observational Studies
Cohort Studies
Logistic Models
Regression Analysis
Physicians

Keywords

  • endoscopy no-show
  • patient no-show
  • procedure no-show

ASJC Scopus subject areas

  • Gastroenterology

Cite this

Predictors of No-show Rate in the GI Endoscopy Suite at a Safety Net Academic Medical Center. / Shuja, Asim; Harris, Ciel; Aldridge, Petra; Malespin, Miguel; del Melo, Silvio.

In: Journal of Clinical Gastroenterology, Vol. 53, No. 1, 01.01.2019, p. 29-33.

Research output: Contribution to journalArticle

Shuja, Asim ; Harris, Ciel ; Aldridge, Petra ; Malespin, Miguel ; del Melo, Silvio. / Predictors of No-show Rate in the GI Endoscopy Suite at a Safety Net Academic Medical Center. In: Journal of Clinical Gastroenterology. 2019 ; Vol. 53, No. 1. pp. 29-33.
@article{baf96d407dc94dc8af659ef2e25ed865,
title = "Predictors of No-show Rate in the GI Endoscopy Suite at a Safety Net Academic Medical Center",
abstract = "Background/Objectives: Noncompliance with physician and procedure appointments is associated with poor disease control and worse disease outcomes. This also impacts the quality of care, decreases efficiency, and affects revenue. Studies have shown that no-show rates are higher in clinics caring for underserved populations and may contribute to poorer health outcomes in this group. Methods: We performed a 17-month retrospective observational cohort study of patients scheduled for outpatient procedures in the Gastroenterology endoscopy suite at the University of Florida Health, Jacksonville. Multivariate logistic regression analysis was performed to evaluate associations between attendance and predictors of no-show. Results: In total, 6157 patients were scheduled to undergo different GI procedures during the study period. A total of 4388 (71{\%}) patients completed their procedure, whereas 2349 (29{\%}) failed to attend their appointment and were considered {"}no-show{"}. There was a significant relationship between the visit attendance and race, insurance, gender, and marital status. Males had a higher no-show rate compared with females (30{\%} vs. 28{\%}; P<0.05). African Americans had the highest no-show rate (32{\%}; P<0.05) amongst different races. Patients scheduled for surveillance colonoscopy (ie, history of polyps, IBD, Colon cancer) were more likely to show (78{\%}) than those obtaining initial colorectal cancer screening (74{\%}) or other indications (71{\%}) (P<0.05). In the logistic regression model, patients with commercial insurance are more likely to show for their appointments than those with noncommercial insurance (eg, Medicare, Medicaid, City contract etc) [odds ratio (OR), 2.6; 95{\%} confidence interval (CI), 2.2-3.0]. The odds of showing up are 1.7 times higher for married men compared with single men (OR, 1.7; 95{\%} CI, 1.3-2.0). Similarly, married females are more likely to show up for appointment than single females (OR, 1.1; 95{\%} CI, 0.9-1.3). We did not find significant association between the type of GI procedure (eg, colonoscopy vs. esophagogastroduodenoscopy vs. advanced endoscopic procedures) (P>0.05). Conclusions: Predictors of no-shows for endoscopic gastrointestinal procedures included unpartnered or single patients, African American race and noncommercial insurance providers. Patients scheduled for surveillance colonoscopy had better adherence than initial screening. Further studies are required to better characterize these factors and improve adherence to the outpatient appointments based on the identified predictors.",
keywords = "endoscopy no-show, patient no-show, procedure no-show",
author = "Asim Shuja and Ciel Harris and Petra Aldridge and Miguel Malespin and {del Melo}, Silvio",
year = "2019",
month = "1",
day = "1",
doi = "10.1097/MCG.0000000000000928",
language = "English (US)",
volume = "53",
pages = "29--33",
journal = "Journal of Clinical Gastroenterology",
issn = "0192-0790",
publisher = "Lippincott Williams and Wilkins",
number = "1",

}

TY - JOUR

T1 - Predictors of No-show Rate in the GI Endoscopy Suite at a Safety Net Academic Medical Center

AU - Shuja, Asim

AU - Harris, Ciel

AU - Aldridge, Petra

AU - Malespin, Miguel

AU - del Melo, Silvio

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Background/Objectives: Noncompliance with physician and procedure appointments is associated with poor disease control and worse disease outcomes. This also impacts the quality of care, decreases efficiency, and affects revenue. Studies have shown that no-show rates are higher in clinics caring for underserved populations and may contribute to poorer health outcomes in this group. Methods: We performed a 17-month retrospective observational cohort study of patients scheduled for outpatient procedures in the Gastroenterology endoscopy suite at the University of Florida Health, Jacksonville. Multivariate logistic regression analysis was performed to evaluate associations between attendance and predictors of no-show. Results: In total, 6157 patients were scheduled to undergo different GI procedures during the study period. A total of 4388 (71%) patients completed their procedure, whereas 2349 (29%) failed to attend their appointment and were considered "no-show". There was a significant relationship between the visit attendance and race, insurance, gender, and marital status. Males had a higher no-show rate compared with females (30% vs. 28%; P<0.05). African Americans had the highest no-show rate (32%; P<0.05) amongst different races. Patients scheduled for surveillance colonoscopy (ie, history of polyps, IBD, Colon cancer) were more likely to show (78%) than those obtaining initial colorectal cancer screening (74%) or other indications (71%) (P<0.05). In the logistic regression model, patients with commercial insurance are more likely to show for their appointments than those with noncommercial insurance (eg, Medicare, Medicaid, City contract etc) [odds ratio (OR), 2.6; 95% confidence interval (CI), 2.2-3.0]. The odds of showing up are 1.7 times higher for married men compared with single men (OR, 1.7; 95% CI, 1.3-2.0). Similarly, married females are more likely to show up for appointment than single females (OR, 1.1; 95% CI, 0.9-1.3). We did not find significant association between the type of GI procedure (eg, colonoscopy vs. esophagogastroduodenoscopy vs. advanced endoscopic procedures) (P>0.05). Conclusions: Predictors of no-shows for endoscopic gastrointestinal procedures included unpartnered or single patients, African American race and noncommercial insurance providers. Patients scheduled for surveillance colonoscopy had better adherence than initial screening. Further studies are required to better characterize these factors and improve adherence to the outpatient appointments based on the identified predictors.

AB - Background/Objectives: Noncompliance with physician and procedure appointments is associated with poor disease control and worse disease outcomes. This also impacts the quality of care, decreases efficiency, and affects revenue. Studies have shown that no-show rates are higher in clinics caring for underserved populations and may contribute to poorer health outcomes in this group. Methods: We performed a 17-month retrospective observational cohort study of patients scheduled for outpatient procedures in the Gastroenterology endoscopy suite at the University of Florida Health, Jacksonville. Multivariate logistic regression analysis was performed to evaluate associations between attendance and predictors of no-show. Results: In total, 6157 patients were scheduled to undergo different GI procedures during the study period. A total of 4388 (71%) patients completed their procedure, whereas 2349 (29%) failed to attend their appointment and were considered "no-show". There was a significant relationship between the visit attendance and race, insurance, gender, and marital status. Males had a higher no-show rate compared with females (30% vs. 28%; P<0.05). African Americans had the highest no-show rate (32%; P<0.05) amongst different races. Patients scheduled for surveillance colonoscopy (ie, history of polyps, IBD, Colon cancer) were more likely to show (78%) than those obtaining initial colorectal cancer screening (74%) or other indications (71%) (P<0.05). In the logistic regression model, patients with commercial insurance are more likely to show for their appointments than those with noncommercial insurance (eg, Medicare, Medicaid, City contract etc) [odds ratio (OR), 2.6; 95% confidence interval (CI), 2.2-3.0]. The odds of showing up are 1.7 times higher for married men compared with single men (OR, 1.7; 95% CI, 1.3-2.0). Similarly, married females are more likely to show up for appointment than single females (OR, 1.1; 95% CI, 0.9-1.3). We did not find significant association between the type of GI procedure (eg, colonoscopy vs. esophagogastroduodenoscopy vs. advanced endoscopic procedures) (P>0.05). Conclusions: Predictors of no-shows for endoscopic gastrointestinal procedures included unpartnered or single patients, African American race and noncommercial insurance providers. Patients scheduled for surveillance colonoscopy had better adherence than initial screening. Further studies are required to better characterize these factors and improve adherence to the outpatient appointments based on the identified predictors.

KW - endoscopy no-show

KW - patient no-show

KW - procedure no-show

UR - http://www.scopus.com/inward/record.url?scp=85058543662&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85058543662&partnerID=8YFLogxK

U2 - 10.1097/MCG.0000000000000928

DO - 10.1097/MCG.0000000000000928

M3 - Article

C2 - 28961577

AN - SCOPUS:85058543662

VL - 53

SP - 29

EP - 33

JO - Journal of Clinical Gastroenterology

JF - Journal of Clinical Gastroenterology

SN - 0192-0790

IS - 1

ER -