Telehealth Reduces No-Show Rates, Improves Access Among Surgical Patients

A study presented at a recent America College of Surgeons (ACS) conference found that telehealth helped decrease no-show rates among surgical patients and led to improved healthcare access.

With more than 84,000 members, ACS centers its efforts on improving the care provided to surgical patients and maintaining an ethical practice environment for surgery. The results of the study were presented at ACS' Clinical Congress 2022.

For the study, researchers aimed to determine the impact telehealth has on the rate of no-show visits. Using data from the University of Alabama Birmingham, gathered between January 2018 and December 2021, researchers created three groups.

These groups consisted of a historical control group of data from in-person visits between January 2018 and March 2020, a contemporary control group of in-person visits between March 2020 and December 2021, and a contemporary group of patients scheduled for telehealth visits between March 2020 and December 2021. After noting that March 2020 was the beginning of the COVID-19 pandemic, researchers evaluated the three groups for no-show rates.

There were 553,475 total visits between the three groups, 11.3 percent of whom were no-shows. Researchers also found that the most clinic visits occurred among the historical control group (54.1 percent), compared to the contemporary control group (41.5 percent).

They also found that the no-show rate was 11.7 percent in the in-person cohort, higher than the 2.5 percent in the telehealth group. A multivariable-adjusted analysis of telemedicine visits revealed that telemedicine reduced the likelihood of a no-show by 79 percent.

"Telemedicine is a feasible way for us to reach out to patients who would otherwise have a lot of barriers to access the healthcare system,” said lead study author Connie Shao, MD, a general surgery resident at the University of Alabama Birmingham, in a press release.

But researchers found differences in now-show rates among various demographics. For example, no-shows were less common among those who were older, Medicare beneficiaries, and in the historical control group.

Further, Medicaid patients were twice as likely as privately insured patients to not complete an appointment. Those from a county with a higher social vulnerability index were 13 percent more likely to have incomplete appointments. 

The researchers also noted other disparities in no-show visits. Male patients were 12 percent more like to have incomplete appointments than women. Black patients were 68 percent more likely, and Asian patients were 32 percent more likely than White patients to no-show.

“Hopefully with the convenience of telemedicine now, the only bridge that we have to cross is the digital divide. We’ve partnered with a grassroots community program to train people in our community, especially older and more vulnerable people, on how to use telemedicine,” said Shao. “We can help keep these patients engaged in the healthcare system without having to take up their entire day to come and see us in the hospital.”

Various providers have engaged in efforts to improve healthcare access through virtual care.

For example, in October, Penn Medicine created a virtual care program to improve access to fertility care for those who were struggling to conceive. They found that the program led to lower wait times, more patients served, lower no-show rates, and higher satisfaction levels.