title: No-show rates in the vascular laboratory: analysis and possible solutions.
abstract: OBJECTIVE
  To report the consequence of missed appointments ("no-shows") in the noninvasive vascular laboratory of a large teaching hospital and evaluate the effect of one potential solution.
  
  
  METHODS
  The financial effect of missed appointments by outpatients during a 9-month period was calculated on the basis of weighted average reimbursement rates for the technical component of a bilateral venous duplex examination. In addition, the effect of an automated telephone reminder system on the no-show rate was studied over a subsequent 17-month period.
  
  
  RESULTS
  The overall no-show rate for outpatients in the vascular laboratory was 12%, with an average of 7.6 missed appointments per week. This translated to a gross annual revenue loss of $89,107 assuming a per-appointment revenue equal to the 2005 technical component of the reimbursement rate for outpatient bilateral duplex venous ultrasound studies. Of the 8,766 patients offered automated reminder calls, 4,648 (53%) agreed to receive the calls. The no-show rate was significantly greater for those patients who chose to receive automated reminder calls (8.9% vs 5.9%, P < .0001).
  
  
  CONCLUSIONS
  A 12% no-show rate offers an opportunity for significant cost savings and improved efficiency in the vascular laboratory. Automated reminder systems did not appear to significantly reduce the no-show rate. Various strategies are outlined to achieve the goal of a 5% no-show rate, including methods of scheduling, pre-examination notification, and advanced overbooking techniques. Further investigation into these strategies to reduce the no-show rate is needed.
authors.affiliation: Peripheral Vascular Laboratory, Ross Heart Hospital, Ohio State University School of Medicine, Columbus, OH 43210, USA. Bhagwan.satiani@osumc.edu
authors.forename: Bhagwan
authors.initials: B
authors.lastname: Satiani
authors.forename: Susan
authors.initials: S
authors.lastname: Miller
authors.forename: Darshan
authors.initials: D
authors.lastname: Patel
mesh_terms: D001071:Appointments and Schedules; D017046:Cost Savings; D003362:Cost-Benefit Analysis; D017721:Hospital Costs; D006784:Hospitals, Teaching / Q000191:economics*; D006801:Humans; D007349:Insurance, Health, Reimbursement; D010044:Outpatient Clinics, Hospital / Q000191:economics*; D010349:Patient Compliance; D017010:Reminder Systems / Q000191:economics*; D012189:Retrospective Studies; D013689:Telephone / Q000191:economics; D018616:Ultrasonography, Doppler, Duplex / Q000191:economics*; D014680:Veins / Q000000981:diagnostic imaging*