Preoperative waiting time and no-show risk in day surgery: a large-scale cohort study

Background No-shows in day surgery represent a global challenge that undermines healthcare efficiency, leading to substantial resource waste and increased operational costs. Preoperative waiting time is a key factor influencing patient attendance. This study investigated the association between preoperative waiting time and the risk of day-surgery no-shows. Methods This retrospective cohort study included 79,516 day-surgery patients. Demographic characteristics, surgical information, and preoperative waiting time were extracted from the electronic medical record system. Patients were categorized into quartiles according to waiting time: Q1 (0–<3 days), Q2 (3–<6 days), Q3 (6–<11 days), and Q4 (≥11 days). Multivariable logistic regression and restricted cubic spline (RCS) analyses were performed to quantify the association between preoperative waiting time and no-show risk. Results Among the 79,516 patients undergoing day surgery, 2,009 (2.53%) experienced no-show. The median waiting time was 6 (3–11) days. After adjusting for confounding factors, longer preoperative waiting was significantly associated with increased odds of no-shows( p < 0.001). RCS analysis revealed a nonlinear dose–response relationship ( p for trend <0.001; p for nonlinearity <0.001). The no-show risk rose sharply when waiting time exceeded approximately 6 days. Conclusion Our data showed a significant association between longer preoperative waiting time and an increased risk of no-show among day-surgery patients. This association became more apparent when the preoperative waiting time exceeded approximately 6 days. These findings provide preliminary quantitative evidence regarding the relationship between preoperative waiting time and no-show risk in day surgery.