title: Prevalence and predictors of patient no-shows to outpatient endoscopic procedures scheduled with anesthesia.
abstract: BACKGROUND
  Demand for endoscopic procedures scheduled with anesthesia is increasing and no-show to appointments carries significant patient health and financial impact, yet little is known about predictors of no-show.
  
  
  METHODS
  We performed a 16-month retrospective observational cohort study of patients scheduled for outpatient endoscopy with anesthesia at a county hospital serving the safety-net healthcare system of San Francisco. Multivariate logistic regression analysis was performed to evaluate associations between attendance and predictors of no-show.
  
  
  RESULTS
  In total, 511 patients underwent endoscopy with anesthesia during the study period. Twenty-seven percent of patients failed to attend an appointment and were considered "no-show". In multivariate analysis, higher no-show rates were associated with patients with a prior history of no-show (odds ratio [OR] 6.4; 95% confidence interval [CI], 2.4- 17.5), those with active substance abuse within the past year (OR 2.2; 95% CI 1.4-3.6), those with heavy prescription opioids/benzodiazepines use (OR 1.6; 95% CI 1.0-2.6) and longer wait-times (OR 1.05; 95% CI 1.00-1.09). Inversely associated with patient no-show were active employment (OR 0.38; 95% CI 0.18-0.81), patients who attended a pre-operative appointment with an anesthesiologist (OR 0.52; CI 0.32-0.85), and those undergoing an advanced endoscopic procedure (OR 0.43; 95% CI 0.19-0.94).
  
  
  CONCLUSIONS
  In a safety-net healthcare population, behavioral and social determinants of health, including missed appointments, active substance abuse, homelessness, and unemployment are associated with no-shows to endoscopy with anesthesia.
authors.affiliation: Division of Gastroenterology, Department of Medicine, University of California, San Francisco, CA, USA. jennifertchang@gmail.com.
authors.forename: Jennifer T
authors.initials: JT
authors.lastname: Chang
authors.affiliation: Division of Gastroenterology, Department of Medicine, San Francisco General Hospital and Trauma Center, San Francisco, CA, USA. sewellj@medsfgh.ucsf.edu.
authors.forename: Justin L
authors.initials: JL
authors.lastname: Sewell
authors.affiliation: Division of Gastroenterology, Department of Medicine, San Francisco General Hospital and Trauma Center, San Francisco, CA, USA. lukejohn.day@ucsf.edu.
authors.forename: Lukejohn W
authors.initials: LW
authors.lastname: Day
mesh_terms: D000328:Adult; D000368:Aged; D000553:Ambulatory Care / Q000706:statistics & numerical data*; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000758:Anesthesia / Q000706:statistics & numerical data*; D001569:Benzodiazepines / Q000627:therapeutic use; D004651:Employment / Q000706:statistics & numerical data; D016099:Endoscopy, Gastrointestinal / Q000706:statistics & numerical data*; D005260:Female; D006766:Hospitals, County / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067455:No-Show Patients / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D064876:Safety-net Providers / Q000706:statistics & numerical data; D012495:San Francisco; D019966:Substance-Related Disorders / Q000453:epidemiology; D013997:Time Factors; D014850:Waiting Lists
chemical_list: D000701:Analgesics, Opioid; D001569:Benzodiazepines