title: Factors associated with non-attendance at a hand surgery appointment.
abstract: BACKGROUND
  Patients who miss scheduled appointments without notifying office staff--"no-shows"--disrupt practice workflow and decrease access for others, resulting in misuse of resources and lost revenue. The primary purpose of this study was to identify factors associated with no-shows in a hospital-based outpatient hand office. Secondarily, we studied factors associated with cancelations.
  
  
  METHODS
  Of the 14,793 new adult patient appointments to our outpatient hand surgery office scheduled between January 2011 and December 2013, 880 (5.9 %) were no-shows and 2715 (18 %) were cancelations. Data on patient demographics and timing of the visit were collected to construct a multinomial logistic regression model of determinants of appointment no-shows and cancelations.
  
  
  RESULTS
  Factors independently associated with no-shows included younger age, Hispanic or black race, unmarried status (single or divorced), appointment on a Monday or Tuesday, and residence near the office. Factors associated with cancelations were female sex, unmarried status (widowed or divorced), winter season, and appointment on a weekday other than Friday.
  
  
  CONCLUSIONS
  Non-attendees are more likely to be younger, unmarried, non-white, to have their appointments at the start of the week, and to live near the office. Knowledge of these factors might prove useful for implementation of tailored quality improvement initiatives to reduce non-attendance and maximize productivity in the hand surgery office setting.
  
  
  METHODS
  Prognostic IV.
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Suite 2100, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: Mariano E
authors.initials: ME
authors.lastname: Menendez
authors.affiliation: Orthopaedic Hand and Upper Extremity Service, Yawkey Center, Suite 2100, Massachusetts General Hospital, 55 Fruit Street, Boston, MA 02114 USA.
authors.forename: David
authors.initials: D
authors.lastname: Ring
keywords: Appointments; Cancelations; Hand surgery; No-shows