Patient No-Shows and Their Impact on the Operational Efficiency of an Ophthalmology Department: Evidence from the Local Health Unit of Central Alentejo

Abstract

Introduction: Patient no-shows to outpatient appointments are one of the main sources of waste in healthcare services, reducing efficiency, access, and the quality of care provided. Ophthalmology is a high-demand specialty and patient no-shows can significantly impact waiting times. Objective: To determine the effect of patient no- shows on the operational efficiency of the Ophthalmology Department at the Local Health Unit of Central Alentejo during 2023. Methodology: A retrospective observational study was conducted, based on electronic records of scheduled medical appointments and diagnostic and therapeutic procedures (DTP) during 2023 in the Ophthalmology Department. A total of 44,948 appointments were analyzed, of which 37,487 were planned appointments. Results: The no-show rate (NSR) ranged from 8% to 13% for medical appointments and DTP, respectively. First-time appointments were more vulnerable to no-shows, and the subspecialties of retinopathy of prematurity and pediatric ophthalmology/strabismus recorded the highest NSRs (24.5% and 18.4%, respectively). Among DTP, the highest NSR was observed in orthoptic assessments and respective treatment sessions (23% and 29%, respectively). No-shows negatively affect the clinical pathway of patients and unbalance the workload of healthcare professionals. Conclusion: Patient no-shows significantly impact the operational efficiency of the Ophthalmology Department, resulting in hundreds of lost working days and frequent reorganization of clinical schedules. These findings highlight the need for preventive strategies and optimization of internal procedures to promote more efficient resource management, improve service performance, and consequently enhance access to care.