Systematic review and meta-analysis of no show or non-attendance rates among telehealth and in-person models of care

• Published in: BMC Health Services Research
• Main Authors: Edwin Phillip Greenup, Daniel Best
• Format: Article
• Language: English
• Published: BMC 2025-05-01
• Subjects: No show; Fail to attend; Non-attendance; Attendance; Virtual care; Telehealth
• Online Access: https://doi.org/10.1186/s12913-025-12826-2

Abstract Objectives Comparisons of no-show rates between virtual and in-person models of care are commonly reported during evaluation, indicating how coveted improvements in attendance are to health service providers. This study seeks to synthesise the data from studies that make these comparisons, providing a more accurate indication of what may expected from the use of virtual care models for clinicians and administrators. Study design Systematic review and meta-analysis of 45 retrospective cohort studies. Methods A literature review involving five databases was conducted, identifying 441 articles for screening. 45 were included for further analysis. A Random effects model was used to calculate the effect size, with further analysis conducted to determine heterogeneity and publication bias. Results The Random effects model estimated a reduced likelihood non-attendance in patients receiving virtual care compared to in-person groups (OR = 0.61). An I2 indicated a high degree of heterogeneity among the studies analysed. The Fail-Safe N suggested that the results are robust and not significantly influenced by publication bias. Conclusions The meta-analysis indicated that on average, telehealth models of care implemented since COVID-19 provide a moderate reduction in risk of patient non-attendance when compared to in-person alternatives.