Title | Patient no-show predictive model development using multiple data sources for an effective overbooking approach. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Huang, Y, Hanauer, DA |
Journal | Appl Clin Inform |
Volume | 5 |
Issue | 3 |
Pagination | 836-60 |
Date Published | 2014 |
ISSN | 1869-0327 |
Abstract | BACKGROUND: Patient no-shows in outpatient delivery systems remain problematic. The negative impacts include underutilized medical resources, increased healthcare costs, decreased access to care, and reduced clinic efficiency and provider productivity.OBJECTIVE: To develop an evidence-based predictive model for patient no-shows, and thus improve overbooking approaches in outpatient settings to reduce the negative impact of no-shows.METHODS: Ten years of retrospective data were extracted from a scheduling system and an electronic health record system from a single general pediatrics clinic, consisting of 7,988 distinct patients and 104,799 visits along with variables regarding appointment characteristics, patient demographics, and insurance information. Descriptive statistics were used to explore the impact of variables on show or no-show status. Logistic regression was used to develop a no-show predictive model, which was then used to construct an algorithm to determine the no-show threshold that calculates a predicted show/no-show status. This approach aims to overbook an appointment where a scheduled patient is predicted to be a no-show. The approach was compared with two commonly-used overbooking approaches to demonstrate the effectiveness in terms of patient wait time, physician idle time, overtime and total cost.RESULTS: From the training dataset, the optimal error rate is 10.6% with a no-show threshold being 0.74. This threshold successfully predicts the validation dataset with an error rate of 13.9%. The proposed overbooking approach demonstrated a significant reduction of at least 6% on patient waiting, 27% on overtime, and 3% on total costs compared to other common flat-overbooking methods.CONCLUSIONS: This paper demonstrates an alternative way to accommodate overbooking, accounting for the prediction of an individual patient's show/no-show status. The predictive no-show model leads to a dynamic overbooking policy that could improve patient waiting, overtime, and total costs in a clinic day while maintaining a full scheduling capacity. |
DOI | 10.4338/ACI-2014-04-RA-0026 |
Alternate Journal | Appl Clin Inform |
PubMed ID | 25298821 |
PubMed Central ID | PMC4187098 |
Research reported in this publication was supported by the National Cancer Institutes of
Health under Award Number P30CA046592. The content is solely the responsibility
of the authors and does not necessarily represent the official views of the
National Institutes of Health.
Research reported in this publication was supported by the National Cancer Institutes of
Health under Award Number P30CA046592 by the use of the following Cancer Center
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