Predictors of No-Show Status: An Analysis of Pediatric Ophthalmology Patients at an Academic Ophthalmology Department in the United States

Purpose: To identify pediatric patient and appointment characteristics associated with no-show status at a tertiary care pediatric ophthalmology clinic within a U.S. academic ophthalmology department. Methods: A cross-sectional retrospective chart review was performed for all pediatric patients with a scheduled ophthalmology appointment at the Penn State Eye Center between April 1, 2022 and March 31, 2023. A multivariate logistic regression analysis assessed associations between appointment nonattendance and patient characteristics. Results: Of 8,083 scheduled visits, 1,445 (17.9%) were no-shows. Factors associated with no-show status included appointment type (new vs return odds ratio [OR]: 1.43, 95% CI: 1.26 to 1.63, P <.001); lower median household income (< $41,374 vs > $68,957 OR: 1.89, 95% CI: 1.40 to 2.55, P <.001; $41,374 to $68,957 vs > $68,957 OR: 1.27, 95% CI: 1.12 to 1.44, P <.001); non-private insurance (self-pay vs private: OR: 5.65, 95% CI: 3.87 to 8.24, P <.001, Medicaid vs private: OR: 2.17, 95% CI: 2.32 to 3.16, P <.001); commute distance 10 to 30 miles vs < 5 miles (OR: 1.49, 95% CI: 1.11 to 1.99, P =.008); race: unavailable vs White (OR: 2.18, 95% CI: 1.66 to 2.85, P <.001), Black vs White (OR: 1.86, 95% CI:1.53 to 2.27, P <.001), Other vs White (OR: 1.47, 95% CI: 1.27 to 1.70, P <.001); ethnicity: Hispanic vs non-Hispanic (OR: 1.92, 95% CI: 1.62 to 2.27, P <.001); and language preference: Spanish vs English (OR: 1.86, 95% CI: 1.49 to 2.32, P <.001), Nepali vs English (OR: 1.60, 95% CI: 1.06 to 2.43, P =.027), other vs English (OR: 1.83, 95% CI: 1.35 to 2.49, P <.001). Appointment reminders (phone call, P =.013); text message, P <.001; other, P =.013) all resulted in a greater propensity to show, but email communication alone did not (P =.674). Conclusions: Certain patient and appointment characteristics that are linked to a higher rate of no-show status can inform targeted initiatives to improve health care outcomes, resource utilization, and clinical efficiency in the pediatric ophthalmology community.