What Is a Normal No-Show Rate? What the Research Says, and Why Yours Is Different

Work out your own rateDownload the no-show benchmark worksheet (PDF)

What the research found

The most thorough summary is a 2018 systematic review in Health Policy by Dantas and colleagues, which analysed 105 studies of no-shows in appointment scheduling. It found an average no-show rate of the order of 23%, highest in Africa (43.0%) and lowest in Oceania (13.2%). The factors most often linked with no-shows were a long lead time between booking and appointment, and a history of previous no-shows; younger adults, lower income, living further from the clinic and not having private insurance also appeared.

A US study of a large Veterans Affairs medical center and ten regional hospitals, published in BMC Health Services Research, found a mean no-show rate of 18.8% across ten main clinics, highest in specialist clinics. A centralised phone reminder system brought the rate down only modestly there, from 16.3% to 15.8%.

Two things stand out. The range is enormous, so "the average" hides more than it shows. And almost all independent, peer-reviewed data is from healthcare. Salons, trainers, tutors, consultants and trades rarely publish theirs, and the figures that circulate for those industries usually come from software companies' own customer data, which is worth reading with that in mind.

Why your rate differs from any average

The research explains much of the variation, and the same factors are easy to check in your own calendar:

• Lead time. An appointment booked six weeks ahead is easier to forget, and plans change. The Dantas review names high lead time as one of the most commonly reported predictors.
• Previous no-shows. The other most common predictor. A small group of repeat no-shows can account for a large share of your total.
• New versus returning clients. Someone who has never met you has less reason to feel they are letting you down.
• Price and commitment. Whether anything was paid up front changes how firm a booking feels.
• Reminders. A Cochrane review of eight trials found attendance at healthcare appointments of 67.8% with no reminders and 78.6% with text message reminders, though the authors rate the evidence as low to moderate quality.

Because these differ between businesses, a salon at 8% and a clinic at 20% may both be doing well for their mix of clients.

Build your own benchmark, step by step

1. Work out three to six months

Use the counting rules in our post on the no-show rate formula: divide by booked, keep late cancellations as a separate rate, same cut-off every month.

2. Split by lead time

Appointments booked within a week, one to two weeks ahead, and further out. This is the split the research points to first.

3. Split by new and returning clients

And, if you can, people who have missed before.

4. Look for the worst group

Whichever group has the highest rate is where a change (an extra reminder, a deposit, a confirmation call) will move your overall number most.

5. Set a target from your baseline

A target of "a quarter fewer no-shows than last quarter" is more useful than "the industry average". The no-show rate calculator has a target field that shows what reaching it is worth a month and a year.

6. Recheck in three months

Same rules, same split. If the worst group improved and the rest stayed put, the change worked.

Using a published average without being misled by it

If you do quote or compare against a published figure, three checks keep it honest:

1. Who was measured? A rate from hospital outpatient clinics says little about a dog groomer. Look for the setting before the number.
2. How was it counted? Some studies count late cancellations as no-shows and some do not; some divide by appointments kept. A different method can move a rate by several points.
3. Who published it? A figure from a company selling reminder software may be accurate, but it comes from its own customers, who chose to buy reminder software.

None of that makes the figures useless. They tell you roughly what range is common in a setting. They just cannot tell you whether your own rate is good, because that depends on your clients, your prices and how far ahead people book.

A worked example

A hair salon looks at three months: 410 appointments booked, 33 no-shows, an overall rate of 8.0%. Split by lead time, the picture changes. Of the 210 appointments booked within a week, 8 were no-shows (3.8%). Of the 200 booked two weeks or more ahead, 25 were (12.5%).

So the salon does not have an 8% problem. It has a far-ahead-booking problem. A second reminder a day or two before for appointments booked more than two weeks out, or a small deposit for them, targets the group that produces three quarters of the no-shows.

If that brought the far-ahead rate down to the near-term rate, the overall figure would fall to roughly 4%. At an average of $65 a visit, the calculator puts the value of going from about 11 no-shows a month to about 5 at about $360 a month. Open it with the monthly figures.

In Fynl, reminder emails go out at the times you set for each booking calendar, with reschedule and cancel links, and a booking calendar can ask for a deposit through your Stripe account, so a far-ahead calendar and a near-term one can have different rules.

You will find the calculator, and a free booking page to put reminders and rescheduling in place, on our free tools page.

Questions people also ask

Sources

• Dantas et al., No-shows in appointment scheduling: a systematic literature review, Health Policy (2018)
• Kheirkhah et al., Prevalence, predictors and economic consequences of no-shows, BMC Health Services Research (2016)
• Cochrane — Mobile phone messaging reminders for attendance at healthcare appointments (2013)