Background and Aims
Preventing missed appointments, or “no-shows,” is an important target in improving
efficient patient care and lowering costs in gastrointestinal endoscopy practices.
We aimed to investigate whether a nurse telephone call would reduce no-show rates
for endoscopic appointments, and to determine if hiring and maintaining a nurse dedicated
to pre-endoscopy phone calls is economically advantageous. Our secondary aim was to
identify predictors of no-shows to endoscopy appointments.
Methods
We hired and trained a full-time licensed nurse to make a telephone call to patients
7 days before their scheduled upper endoscopy or colonoscopy. We compared this intervention
with a previous reminder system involving mailed reminders. The effect of the intervention
and impact of other predictors of no-shows were analyzed in 2 similar preintervention
and postintervention patient cohorts. A mixed effects logistic regression model was
used to estimate the association of the odds of being a no-show to the scheduled appointment
and the characteristics of the patient and visit. An analysis of costs was performed
that included the startup and maintenance costs of the intervention.
Results
We found that a nurse phone call was associated with a 33% reduction in the odds of
a no-show visit (odds ratio, 0.67; 95% confidence interval, 0.50-0.91), adjusting
for gender, age, partnered status, insurer type, distance from the endoscopy center,
and visit type. The recovered reimbursement during the study period was $48,765, with
net savings of $16,190 when accounting for the maintenance costs of the intervention;
this resulted in a net revenue per annum of $43,173.
Conclusions
We found that endoscopy practices may increase revenue, improve scheduling efficiency,
and maximize resource utilization by hiring a nurse to reduce no-shows. Predictors
of no-shows to endoscopy included unpartnered or single patients, commercial or managed
care, being scheduled for colonoscopy as opposed to upper endoscopy, and being scheduled
for a screening or surveillance colonoscopy.
Abbreviations:
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Article info
Publication history
Published online: June 17, 2016
Accepted:
May 30,
2016
Received:
January 5,
2016
Footnotes
DISCLOSURE: All authors disclosed no financial relationships relevant to this publication.
See CME section; p. 1021.
If you would like to chat with an author of this article, you may contact Dr Childers at [email protected]
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Copyright © 2016 by the American Society for Gastrointestinal Endoscopy
