The Prevalence of No-Shows and Cancellations Rate in Outpatient Physical Therapy Practice and Its Relationship to Age and Gender

Abstract

Background: No-Show and late canceled appointments significantly impact out-patient Physical therapist productivity, patient clinical outcomes, and the clinic's revenue-generating capacity. No-show and appointment cancelation cost the out-patient Physical Therapy practice in this case study $114,505.58CAD in 2017. This study seeks to understand, identify, and provide solutions unique to our local setting for the problem of no-shows and appointment cancellation. Methods: This study uses the 2017 de-identified patient's attendance records of an out-patient Physical Therapy clinic in Calgary, Canada. Patient data, including sex, age, scheduled appointment, no-show, and cancellation history, were examined. The data were analyzed using chi-square to determine any significant differences in attendance patterns among these groups. Results: A total of 6,162 scheduled appointments were aggregated from the EHR. The overall no-show and cancelation was 20.6%. Male had a slightly higher rate of no-show/cancelation (20.8%) versus females (20.6%), which was not statistically significant (p = 0.734). In the adult age groups, no-show and cancelation rates were highest for 12-20y/o (31.4%), 21-30y/o (31.3%), and 41-50y/o (22.3%). These groups accounted for 50.6% of total revenue loss. There was a significant overall difference among the age groups (p < 0.0001) in no-show/cancelation. The top four reasons for no-show and cancellation include forgetting the appointment, family and personal emergency, lack of transportation, and a scheduling conflict with another equally important appointment. Conclusion: Evidence indicates that no-show and appointment cancelation rates are high in Canadian health institutions leading to poor productivity, inefficiency, and revenue loss. This study seeks to provide an evidence-based intervention.