Abstract Details

Title Determinants of Late Cancellation and No-show Appointments Across General and Subspecialty Neurology Clinics

Topic Practice, Policy, and Ethics

Presentation(s) P2 - Poster Session 2 (11:45 AM-12:45 PM)

Poster/Presentation
Number 14-002

Objective To identify key factors contributing to Late Cancellations (LC) and No-Shows (NS) by analyzing provider levels (Experienced, Early-career; Male/Female physicians, Fellows, Advanced Practice Providers), socioeconomic variables (Race, Medicare, Medicaid, Area Deprivation Index [ADI]), and visit-type (New, Return, Video, Hospital follow-up and Reassign) across Academic General Neurology (GN) and nine subspecialty clinics (SCs: Cognitive, Community, Epilepsy, Headache, Movement, Neuroimmunology, Neuromuscular, Stroke, Women’s). The goal was to improve patient access and optimize healthcare efficiency through better resource utilization.

Background LC and NS negatively affect healthcare efficiency, prolong wait-time, and reduce quality of care. Previous studies linked these patterns to socioeconomic disparities, underscoring the need for further analyses.

Design/Methods Data from 1/1/2025–8/31/2025 were obtained using UPMC Neurology Department QlikSense’s Epic Scheduled Appointments dashboard (47,220 patients; 93,010 appointments). Analyses were conducted in Prism software using Pearson’s correlation (r > 0.96) and p-values (p > 0.05), comparing neurology specializations across provider, socioeconomic, and visit-type variables.

Results Most SCs demonstrated visit-to-patient ratios similar to GN, except Cognitive, which had a lower ratio likely due to its provider-based care model. Socioeconomic stratification showed higher visit rates in Headache, Movement, Neuroimmunology, and Neuromuscular clinics, suggesting differing access patterns across patient populations. No strong correlations were found between visit volume and LC or NS, though weak associations emerged within provider and visit-type categories. Provider identity had no significant impact. Clinic-level differences revealed significant LC/NS trends by specialty, while socioeconomic behavior remained consistent. Visit-type influence was limited, except for lower NS rates in Neuromuscular. Overall, LC and NS rates were primarily shaped by clinic structure and specialty rather than by provider, socioeconomic status, or visit type.

Conclusions

LC and NS mitigation should focus on clinic-specific strategies rather than provider-level interventions. Expanding specialty clinic access and addressing socioeconomic barriers through patient education, transportation support, and insurance coverage may enhance attendance and overall healthcare efficiency.

Authors/Disclosures
Lakshanya Rajaganapathi PRESENTER	Miss Rajaganapathi has nothing to disclose.
Vijayalakshmi Rajasekaran, MD, FAAN (University of Pittsburgh)	The institution of Dr. Rajasekaran has received research support from UCB Pharmaceutical drug trail . The institution of Dr. Rajasekaran has received research support from Xenon and Biohaven. Dr. Rajasekaran has received personal compensation in the range of $0-$499 for serving as a Consultant with NaoX.
Michael Whalen, MHA	Mr. Whalen has nothing to disclose.
Kimberly Murin	Kimberly Murin has nothing to disclose.
Alexandra Urban, MD, FAAN (University of Pittsburgh School of Medicine)	Dr. Urban has received personal compensation in the range of $0-$499 for serving as a Consultant for Neuropace. Dr. Urban has received personal compensation in the range of $0-$499 for serving as a Consultant for LivaNova.

��ɫ��

��ɫ��