A Cleveland Clinic study of more than 45,000 scheduled outpatient endoscopic procedures found substantial rates of last-minute cancellations and no-shows, particularly at a tertiary academic center. Among 34,129 procedures scheduled at the academic site, 30.2% were canceled within seven days or resulted in a no-show, compared with 18.0% at a community-based endoscopy unit.
The analysis identified several factors associated with missed procedures. At the academic center, every 10-point increase in the Area Deprivation Index (ADI) was associated with 33% higher adjusted odds of cancellation. Medicaid coverage was also associated with higher cancellation odds, while colonoscopy had higher cancellation odds than EGD at both sites.
The findings highlight an operational problem as well as an access issue: an unused endoscopy slot means lost capacity for another patient, potentially extending already lengthy wait times. Researchers are now preparing a prospective study to directly investigate why patients cancel or miss procedures and identify potentially modifiable barriers.