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Year : 2017  |  Volume : 11  |  Issue : 2  |  Page : 262-263

No-show as a cause of surgical cancellation: A mini review from a Middle Eastern perspective

Department of Urology, Ibri Regional Hospital, Ministry of Health, Ibri, Sultanate of Oman

Correspondence Address:
Mohamed Mohamed Elawdy
Ibri Regional Hospital, P.O. Box 618, Ibri
Sultanate of Oman
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sja.SJA_8_17

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Date of Web Publication27-Mar-2017

How to cite this article:
Elawdy MM. No-show as a cause of surgical cancellation: A mini review from a Middle Eastern perspective. Saudi J Anaesth 2017;11:262-3

How to cite this URL:
Elawdy MM. No-show as a cause of surgical cancellation: A mini review from a Middle Eastern perspective. Saudi J Anaesth [serial online] 2017 [cited 2022 Jan 19];11:262-3. Available from:

Abdulaziz AA, et al.[1] reported the 34% of nonshow among the reasons of surgical cancellation (SC) on the analysis of no-show patients at day surgery program in a multidisciplinary 1500-bedded hospital. Although it was a prospectively-designed study, the authors did not give a good clarification for this high percentage of nonshow. As they mentioned, 36% of the patients did not answer over the phone, 30% had personal problems, and 9% thought that the surgeries were canceled by the hospital. We hoped for a better explanation for such miscommunication errors and what could be behind personal problems.

The topic SC is an important economic issue in health administration services, notably in the Middle East region. The operating theater (OT) is an integral part of any hospital and utilizes considerable economic resources and workforce. Proper OT utilization and lower cancellation rates are among good quality indicators.

Worldwide, the reported rate of SC due to patient no-show is ranged 10%–19%,[2],[3] but publications from the Middle East region show different numbers. Studies from different regions in Saudi Arabia show a rate of 32%–42% cancellation due to patient no-show.[4],[5]

Similar figures from a large MOH hospital in Oman indicate 60% no-show [6] and from a teaching hospital in Sudan indicate 35% no-show.[7] Moreover, and in a study from a governmental hospital in Kuwait that targeted patients who were prepared for cataract surgery, 46% of the SC was due to patient no-show.

No-show is defined as individuals who have made, but neither keep, nor cancel their reservation, booking, or appointment.[8]

In our region, heath services are almost completely covered by and sponsored through the government, which does not charge patients for surgical booking or cancellations. Although this could be a cause and main reason for no-shows, this matter requires more investigation.

While financial penalties are an attractive option to minimize patient-related SCs, this option should not be considered until hospital-associated reasons that may lead to patient noncompliance have been identified and managed appropriately. Among these are long waiting lists, hospital quality, and patients' desire to be treated at tertiary hospitals.

Regular audits, proper patient communication, and dedicated OT booking coordinators are a few ways that may help decrease the SC rate due to no-show.

Hopefully, the results of this and similar studies will increase the awareness of the burden of SCs and will encourage hospitals in our region to conduct similar prospective studies and to execute quality analyses. All aims to decrease the no-show rate to the minimum. This will increase OT utilization efficiency and will save a considerable portion of hospital financial resources.

  References Top

Abdulaziz AA, Abdullah TA, Ali HA. Analysis of no show patients at day surgery program in a multidisciplinary 1500 bedded hospital. Saudi J Anaesth In press.  Back to cited text no. 1
Chiu CH, Lee A, Chui PT. Cancellation of elective operations on the day of intended surgery in a Hong Kong hospital: Point prevalence and reasons. Hong Kong Med J 2012;18:5-10.  Back to cited text no. 2
Kumar R, Gandhi R. Reasons for cancellation of operation on the day of intended surgery in a multidisciplinary 500 bedded hospital. J Anaesthesiol Clin Pharmacol 2012;28:66-9.  Back to cited text no. 3
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Sultan N, Rashid A, Abbas SM. Reasons for cancellation of elective cardiac surgery at Prince Sultan Cardiac Centre, Saudi Arabia. J Saudi Heart Assoc 2012;24:29-34.  Back to cited text no. 4
Dhafar KO, Ulmalki MA, Felemban MA, Mahfouz ME, Baljoon MJ, Gazzaz ZJ, et al. Cancellation of operations in Saudi Arabian hospitals: Frequency, reasons and suggestions for improvements. Pak J Med Sci 2015;31:1027-32.  Back to cited text no. 5
Appavu ST, Al-Shekaili SM, Al-Sharif AM, Elawdy MM. The burden of surgical cancellations and no-shows: Quality management study from a large regional hospital in Oman. Sultan Qaboos Univ Med J 2016;16:e298-302.  Back to cited text no. 6
Mutwali IM AA, Elkheir IS, Arbab SS, Bur A, Geregandi T. Cancellation of elective surgical operations in a teaching hospital at Khartoum Bahri, Sudan. Sudan Med Monit2016;11:45-51.  Back to cited text no. 7
  [Full text]  
Oxford University Press, 2017. Available from:  Back to cited text no. 8


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