No-show as a cause of surgical cancellation: A mini review from a Middle Eastern perspective.

Abdulaziz AA, et al.[1] reported the 34% of nonshow among the reasons of surgical cancellation (SC) on the analysis of no-show patients at day surgery program in a multidisciplinary 1500-bedded hospital. Although it was a prospectively-designed study, the authors did not give a good clarification for this high percentage of nonshow. As they mentioned, 36% of the patients did not answer over the phone, 30% had personal problems, and 9% thought that the surgeries were canceled by the hospital. We hoped for a better explanation for such miscommunication errors and what could be behind personal problems.

The topic SC is an important economic issue in health administration services, notably in the Middle East region. The operating theater (OT) is an integral part of any hospital and utilizes considerable economic resources and workforce. Proper OT utilization and lower cancellation rates are among good quality indicators.

Worldwide, the reported rate of SC due to patient no-show is ranged 10%–19%,[23] but publications from the Middle East region show different numbers. Studies from different regions in Saudi Arabia show a rate of 32%–42% cancellation due to patient no-show.[45]

Similar figures from a large MOH hospital in Oman indicate 60% no-show[6] and from a teaching hospital in Sudan indicate 35% no-show.[7] Moreover, and in a study from a governmental hospital in Kuwait that targeted patients who were prepared for cataract surgery, 46% of the SC was due to patient no-show.

No-show is defined as individuals who have made, but neither keep, nor cancel their reservation, booking, or appointment.[8]

In our region, heath services are almost completely covered by and sponsored through the government, which does not charge patients for surgical booking or cancellations. Although this could be a cause and main reason for no-shows, this matter requires more investigation.

While financial penalties are an attractive option to minimize patient-related SCs, this option should not be considered until hospital-associated reasons that may lead to patient noncompliance have been identified and managed appropriately. Among these are long waiting lists, hospital quality, and patients’ desire to be treated at tertiary hospitals.

Regular audits, proper patient communication, and dedicated OT booking coordinators are a few ways that may help decrease the SC rate due to no-show.

Hopefully, the results of this and similar studies will increase the awareness of the burden of SCs and will encourage hospitals in our region to conduct similar prospective studies and to execute quality analyses. All aims to decrease the no-show rate to the minimum. This will increase OT utilization efficiency and will save a considerable portion of hospital financial resources.