Missed Appointments in Nuclear Medicine: What it Costs

Abstract

All hospitals, family practice and outpatient specialty clinics experience the challenges of patient no-shows. Many healthcare facilities have begun to recognize the financial impact of missed appointments. This study aimed to explore the financial consequences of missed appointments and effects of the patient reminder system in a nuclear medicine department. Methods: Patient data was collected from January 2011 through June 2011. Collected data included attendance, type of scheduled examination, reason for examination, examination time, radiopharmaceutical utilized, in-patient or out-patient status and reminder phone call information. Radiopharmaceutical pricing was acquired from the manufacturer. Current Procedural Terminology (CPT) codes and pricing for nuclear medicine procedures were obtained. The total percentage of patient no-shows over the 6-month period was determined. A one-way analysis of variance (ANOVA) test was used to determine the significance of the patient reminder system. Financial loss from ordered radiopharmaceuticals and missed procedures was calculated. Results: A monthly mean no show-rate of 13 ± 2% was found over the 6-month period. The cardiac stress test was the most often performed procedure at this institution. The stress test was also the most frequently missed procedure causing 99mTc tetrofosmin (Myoview) to be the most frequently wasted radiopharmaceutical. The patient reminder system did not reduce patient no-show rates. A total amount of $31,000 was potentially lost in ordered radiopharmaceuticals. There was a potential loss of earnings from missed procedures of $138,000. Conclusion: The nuclear medicine department no-show rate was below the range found in previous studies. The reminder system utilization did not decrease no-show rates. Missed appointments have financial consequences in nuclear medicine departments.