Other Titles
Does Telemedicine Affect Patient No-Shows? [Title Slide]
Abstract
Background: Pediatric patient no-shows to specialty clinic appointments are a problem, with no-show rates as high as 50%. The limited number of pediatric specialty providers leads to longer lead times when rescheduling, further delaying care. One often cited no-show factor is inconvenient appointment access. COVID-19 offered telemedicine as an additional patient access method. In this study, we compared no-show rates before the COVID-19 pandemic with no-show rates during the pandemic and in the post-pandemic period to evaluate (1) the impact of telemedicine patient access on the overall no-show rate for pediatric ambulatory clinic visits and (2) the telemedicine no-show rate compared to in-person no-show rate.
Methods: We analyzed patient demographic, income, and visit data from the pre-Covid-19 pandemic, the pandemic, and post-pandemic periods using a General Linear Model (GLM) and Logistic Regression (LR). We chose GLM and LR to (1) determine the significant factors associated with telemedicine and in-person no-show rates and (2) develop a model to forecast no-shows for in-person and telemedicine appointments in the post-pandemic period. We extracted the data from the health system’s Epic database.
Results: No-show rates dropped from pre-pandemic to pandemic periods (24.5% vs. 21.3%) but rose post-pandemic to 26.3%. Telemedicine rates were lower compared to in-person no-show rates during intra-Covid-19 (19.2% vs. 23.6%) and post-Covid-19 (20.3% vs. 28.5%). Significant factors in the model leading to lower telemedicine no-show rates were Historical No-Show Rate, Income, Lead Time, Telemedicine vs. In-Person, Insurance, and the interaction of Telemedicine vs. In-Person with Insurance. The model indicated which factors to target with interventions to reduce future no-shows. The primary limitations were that we did not measure patient access to telemedicine technology, and generalization was limited to pediatric specialty clinic patients.
Conclusions: Telemedicine patient access was significantly associated with lower pediatric specialty clinic no-shows. Nurses should collaborate with healthcare leaders to ensure telemedicine remains available for the foreseeable future so that pediatric specialty patients can have another access method to care.
Notes
References:
Connolly, S. L., Charness, M. E., & Miller, C. J. (2023). To increase patient use of video telehealth, look to clinicians. Health Services Research, 58(1), 5.
Kobeissi, M. M., & Hickey, J. V. (2023). An infrastructure to provide safer, higher-quality, and more equitable telehealth. The joint commission journal on quality and patient safety, 49(4), 213-222.
Li, T., Liu, Y., Li, M., Qian, X., & Dai, S. Y. (2020). Mask or no mask for COVID-19: A public health and market study. PloS one, 15(8), e0237691. doi:10.1371/journal.pone.0237691
Morgan, Z. J., Bazemore, A. W., Peterson, L. E., Phillips, R. L., & Dai, M. (2024). The disproportionate impact of primary care disruption and telehealth utilization during COVID-19. The Annals of Family Medicine, 22(4), 294-300.
Shah, D. A., Sall, D., Peng, W., Sharer, R., Essary, A. C., & Radhakrishnan, P. (2024). Exploring the role of telehealth in providing equitable healthcare to the vulnerable patient population during COVID-19. Journal of telemedicine and telecare, 30(6), 1047-1050.
Sumarsono, A., Case, M., Kassa, S., & Moran, B. (2023). Telehealth as a tool to improve access and reduce no-show rates in a large safety-net population in the USA. Journal of Urban Health, 100(2), 398-407.
Tilhou, A. S., Jain, A., & DeLeire, T. (2024). Telehealth expansion, internet speed, and primary care access before and during COVID-19. JAMA Network Open, 7(1), e2347686-e2347686
Sigma Membership
Rho
Type
Presentation
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Other
Keywords:
Acute Care, Primary Care, Public and Community Health, Pediatrics, Telemedicine, Adherence to Appointments
Recommended Citation
Medvec, Barbara R.; Hill, Tamara L.; and Knight, John D., "The Impact of Telemedicine on Pediatric Specialty Patients’ Access to Care" (2025). Biennial Convention (CONV). 44.
https://www.sigmarepository.org/convention/2025/presentations_2025/44
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-11-19
The Impact of Telemedicine on Pediatric Specialty Patients’ Access to Care
Indianapolis, Indiana, USA
Background: Pediatric patient no-shows to specialty clinic appointments are a problem, with no-show rates as high as 50%. The limited number of pediatric specialty providers leads to longer lead times when rescheduling, further delaying care. One often cited no-show factor is inconvenient appointment access. COVID-19 offered telemedicine as an additional patient access method. In this study, we compared no-show rates before the COVID-19 pandemic with no-show rates during the pandemic and in the post-pandemic period to evaluate (1) the impact of telemedicine patient access on the overall no-show rate for pediatric ambulatory clinic visits and (2) the telemedicine no-show rate compared to in-person no-show rate.
Methods: We analyzed patient demographic, income, and visit data from the pre-Covid-19 pandemic, the pandemic, and post-pandemic periods using a General Linear Model (GLM) and Logistic Regression (LR). We chose GLM and LR to (1) determine the significant factors associated with telemedicine and in-person no-show rates and (2) develop a model to forecast no-shows for in-person and telemedicine appointments in the post-pandemic period. We extracted the data from the health system’s Epic database.
Results: No-show rates dropped from pre-pandemic to pandemic periods (24.5% vs. 21.3%) but rose post-pandemic to 26.3%. Telemedicine rates were lower compared to in-person no-show rates during intra-Covid-19 (19.2% vs. 23.6%) and post-Covid-19 (20.3% vs. 28.5%). Significant factors in the model leading to lower telemedicine no-show rates were Historical No-Show Rate, Income, Lead Time, Telemedicine vs. In-Person, Insurance, and the interaction of Telemedicine vs. In-Person with Insurance. The model indicated which factors to target with interventions to reduce future no-shows. The primary limitations were that we did not measure patient access to telemedicine technology, and generalization was limited to pediatric specialty clinic patients.
Conclusions: Telemedicine patient access was significantly associated with lower pediatric specialty clinic no-shows. Nurses should collaborate with healthcare leaders to ensure telemedicine remains available for the foreseeable future so that pediatric specialty patients can have another access method to care.
Description
Pediatric in-person clinic appointments limit access to care and have high no-show rates, negatively impacting patient outcomes. The COVID-19 pandemic offered telemedicine as a patient access method. We evaluated pre-pandemic no-show rates with intra-pandemic and post-pandemic no-show rates to determine the impact of telemedicine visits on pediatric specialty clinic no-show rates compared to in-person no-show rates. Our results indicate that telemedicine was associated with lower no-show rates.