IDEAS home Printed from https://ideas.repec.org/a/sae/medema/v33y2013i8p976-985.html
   My bibliography  Save this article

Estimating the Cost of No-Shows and Evaluating the Effects of Mitigation Strategies

Author

Listed:
  • Bjorn P. Berg
  • Michael Murr
  • David Chermak
  • Jonathan Woodall
  • Michael Pignone
  • Robert S. Sandler
  • Brian T. Denton

Abstract

Objective. To measure the cost of nonattendance (“no-shows†) and benefit of overbooking and interventions to reduce no-shows for an outpatient endoscopy suite. Methods. We used a discrete-event simulation model to determine improved overbooking scheduling policies and examine the effect of no-shows on procedure utilization and expected net gain, defined as the difference in expected revenue based on Centers for Medicare & Medicaid Services reimbursement rates and variable costs based on the sum of patient waiting time and provider and staff overtime. No-show rates were estimated from historical attendance (18% on average, with a sensitivity range of 12%–24%). We then evaluated the effectiveness of scheduling additional patients and the effect of no-show reduction interventions on the expected net gain. Results. The base schedule booked 24 patients per day. The daily expected net gain with perfect attendance is $4433.32. The daily loss attributed to the base case no-show rate of 18% is $725.42 (16.4% of net gain), ranging from $472.14 to $1019.29 (10.7%–23.0% of net gain). Implementing no-show interventions reduced net loss by $166.61 to $463.09 (3.8%–10.5% of net gain). The overbooking policy of 9 additional patients per day resulted in no loss in expected net gain when compared with the reference scenario. Conclusions. No-shows can significantly decrease the expected net gain of outpatient procedure centers. Overbooking can help mitigate the impact of no-shows on a suite’s expected net gain and has a lower expected cost of implementation to the provider than intervention strategies.

Suggested Citation

  • Bjorn P. Berg & Michael Murr & David Chermak & Jonathan Woodall & Michael Pignone & Robert S. Sandler & Brian T. Denton, 2013. "Estimating the Cost of No-Shows and Evaluating the Effects of Mitigation Strategies," Medical Decision Making, , vol. 33(8), pages 976-985, November.
    • Handle: RePEc:sae:medema:v:33:y:2013:i:8:p:976-985
    DOI: 10.1177/0272989X13478194
    as

    Download full text from publisher

    File URL: https://journals.sagepub.com/doi/10.1177/0272989X13478194
    Download Restriction: no
    File URL: https://libkey.io/10.1177/0272989X13478194?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Chrwan-Jyh Ho & Hon-Shiang Lau, 1992. "Minimizing Total Cost in Scheduling Outpatient Appointments," Management Science, INFORMS, vol. 38(12), pages 1750-1764, December.
    2. Lawrence R. Weatherford & Samuel E. Bodily, 1992. "A Taxonomy and Research Overview of Perishable-Asset Revenue Management: Yield Management, Overbooking, and Pricing," Operations Research, INFORMS, vol. 40(5), pages 831-844, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Harris, Shannon L. & May, Jerrold H. & Vargas, Luis G. & Foster, Krista M., 2020. "The effect of cancelled appointments on outpatient clinic operations," European Journal of Operational Research, Elsevier, vol. 284(3), pages 847-860.
    2. Aaron Ratcliffe & Ann Marucheck & Sean Xin Xu, 2019. "Regional Planning Model for Cancer Screening with Imperfect Patient Adherence," Service Science, INFORMS, vol. 11(2), pages 113-137, June.
    3. Henry Lenzi & Ângela Jornada Ben & Airton Tetelbom Stein, 2019. "Development and validation of a patient no-show predictive model at a primary care setting in Southern Brazil," PLOS ONE, Public Library of Science, vol. 14(4), pages 1-14, April.
    4. Simsek, Serhat & Dag, Ali & Tiahrt, Thomas & Oztekin, Asil, 2021. "A Bayesian Belief Network-based probabilistic mechanism to determine patient no-show risk categories," Omega, Elsevier, vol. 100(C).
    5. Kazim Topuz & Timothy L. Urban & Robert A. Russell & Mehmet B. Yildirim, 2024. "Decision support system for appointment scheduling and overbooking under patient no-show behavior," Annals of Operations Research, Springer, vol. 342(1), pages 845-873, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Chatwin, Richard E., 2000. "Optimal dynamic pricing of perishable products with stochastic demand and a finite set of prices," European Journal of Operational Research, Elsevier, vol. 125(1), pages 149-174, August.
    2. Tugba Cayirli & Pinar Dursun & Evrim D. Gunes, 2019. "An integrated analysis of capacity allocation and patient scheduling in presence of seasonal walk-ins," Flexible Services and Manufacturing Journal, Springer, vol. 31(2), pages 524-561, June.
    3. Alessandro Avenali & Yuri Maria Chianese & Graziano Ciucciarelli & Giorgio Grani & Laura Palagi, 2019. "Profit optimization in one-way free float car sharing services: a user based relocation strategy relying on price differentiation and Urban Area Values," DIAG Technical Reports 2019-04, Department of Computer, Control and Management Engineering, Universita' degli Studi di Roma "La Sapienza".
    4. Grigoriev, A. & Hiller, B. & Marban, S. & Vredeveld, T. & van der Zwaan, G.R.J., 2010. "Dynamic pricing problems with elastic demand," Research Memorandum 053, Maastricht University, Maastricht Research School of Economics of Technology and Organization (METEOR).
    5. Ma, Jie & Tse, Ying Kei & Wang, Xiaojun & Zhang, Minhao, 2019. "Examining customer perception and behaviour through social media research – An empirical study of the United Airlines overbooking crisis," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 127(C), pages 192-205.
    6. Belobaba, Peter P. & Wilson, John L., 1997. "Impacts of yield management in competitive airline markets," Journal of Air Transport Management, Elsevier, vol. 3(1), pages 3-9.
    7. Hu, Qiying & Wei, Yihua & Xia, Yusen, 2010. "Revenue management for a supply chain with two streams of customers," European Journal of Operational Research, Elsevier, vol. 200(2), pages 582-598, January.
    8. Xiuli Chao & Liming Liu & Shaohui Zheng, 2003. "Resource Allocation in Multisite Service Systems with Intersite Customer Flows," Management Science, INFORMS, vol. 49(12), pages 1739-1752, December.
    9. Chen, Bo & Zhang, Xiandong, 2019. "Scheduling with time-of-use costs," European Journal of Operational Research, Elsevier, vol. 274(3), pages 900-908.
    10. Irene Ng & Nick K.T. Yip, 2009. "Mechanism design in an integrated approach towards revenue management: the case of Empress Cruise Lines," The Service Industries Journal, Taylor & Francis Journals, vol. 31(3), pages 469-482, February.
    11. Chua, Geoffrey A. & Lim, Wei Shi & Yeo, Wee Meng, 2016. "Market structure and the value of overselling under stochastic demands," European Journal of Operational Research, Elsevier, vol. 252(3), pages 900-909.
    12. Slotnick, Susan A., 2011. "Order acceptance and scheduling: A taxonomy and review," European Journal of Operational Research, Elsevier, vol. 212(1), pages 1-11, July.
    13. Mihai Banciu & Fredrik Ødegaard & Alia Stanciu, 2019. "Distribution-free bounds for the expected marginal seat revenue heuristic with dependent demands," Journal of Revenue and Pricing Management, Palgrave Macmillan, vol. 18(2), pages 155-163, April.
    14. Shenghai Zhou & Yichuan Ding & Woonghee Tim Huh & Guohua Wan, 2021. "Constant Job‐Allowance Policies for Appointment Scheduling: Performance Bounds and Numerical Analysis," Production and Operations Management, Production and Operations Management Society, vol. 30(7), pages 2211-2231, July.
    15. J-M Chen & L-T Chen, 2004. "Pricing and lot-sizing for a deteriorating item in a periodic review inventory system with shortages," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 55(8), pages 892-901, August.
    16. Aditya Shetty & Harry Groenevelt & Vera Tilson, 2023. "Intraday dynamic rescheduling under patient no-shows," Health Care Management Science, Springer, vol. 26(3), pages 583-598, September.
    17. Youyi Feng & Baichun Xiao, 2000. "A Continuous-Time Yield Management Model with Multiple Prices and Reversible Price Changes," Management Science, INFORMS, vol. 46(5), pages 644-657, May.
    18. Badinelli, Ralph D., 2000. "An optimal, dynamic policy for hotel yield management," European Journal of Operational Research, Elsevier, vol. 121(3), pages 476-503, March.
    19. Wen-Ya Wang & Diwakar Gupta, 2011. "Adaptive Appointment Systems with Patient Preferences," Manufacturing & Service Operations Management, INFORMS, vol. 13(3), pages 373-389, July.
    20. Mesak, Hani I. & Zhang, Hongkai & Pullis, Joe M., 2010. "On optimal service capacity allocation policy in an advance selling environment in continuous time," European Journal of Operational Research, Elsevier, vol. 203(2), pages 505-512, June.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:sae:medema:v:33:y:2013:i:8:p:976-985. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: SAGE Publications (email available below). General contact details of provider: .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.