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Abstracts

Late Cancellations and No-Shows in an Adult Epilepsy Clinic: An One-Year Analysis of Utilization and Predictive Factors

Abstract number : 1.105
Submission category : 13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year : 2025
Submission ID : 1057
Source : www.aesnet.org
Presentation date : 12/6/2025 12:00:00 AM
Published date :

Authors :
Presenting Author: Alexandra Urban, MD – University of Pittsburgh Medical Center

Vijayalakshmi Rajasekaran, MD – University of Pittsburgh Department of Neurology
James Castellano, MD – UPMC
Anto Bagic, MD, PhD – University of Pittsburgh Department of Neurology

Rationale:

No show and late cancellations (NSLC) in outpatient neurology clinics significantly impact healthcare delivery, contributing to inefficiencies, delayed care, and financial loss. This challenge is amplified in epilepsy clinics, which often serve a younger and publicly insured population with limited mobility and access to care. Understanding the specific patterns of NSLC in specialized epilepsy care is critical for developing targeted interventions.

To analyze NSLC rates over a 12-month period in an adult Level 4 NAEC Epilepsy Center and identify demographic, provider, and appointment-level logistical factors associated with higher NSLC rates.



Methods:

We retrospectively reviewed outpatient visit data from June 2024 to May 2025. The cohort included 5265 patients and 10110 appointments, managed by 11 epileptologists,3 APPs and 6 fellows. NSLC was defined as missed appointments or cancellations within 24 hours. Variables analyzed included patient demographics, social determinants (area of deprivation index (ADI)), appointment characteristics, and provider experience.



Results:

The overall NSLC rate was 24.2%, notably higher than in the general neurology clinic rate (18.7%) and health system average (17.4%). NSLC rates were elevated among patients on Medicaid (40.5%), Blacks (36.4%), those from high ( >85) ADI areas (28.6%) and under 25 years of age. The wastage of new appointments (36.2%), virtual visits (28.3%), those on Fridays (39.6%), with trainees (31.4%), early-career (28.7%) and male physicians (28.3%, N=5) was also higher. NSLC rates were lower for Monday appointments (24%) and with experienced providers ( >10 years, 16.4%).



Conclusions:

Elevated NSLC rates in an epilepsy specialty clinic appear to be significantly influenced by the patient demographics, socioeconomic status, provider experience, and appointment day. The highest-risk subgroups include the younger, Black, and Medicaid-insured patients. , and those seen by trainees or early-career providers. Further thorough analysis is necessary to understand a true impact of provider-related factors. It seems that the targeted interventions (enhanced outreach, reminder systems, and scheduling optimization) may help reduce the NSLC rates and improve an academic epilepsy clinic efficiency.



Funding: N/A

Health Services (Delivery of Care, Access to Care, Health Care Models)