Analysis of socioeconomic and demographic factors and imaging exam characteristics associated with missed appointments in pediatric radiology

Flores, Efrén J.; Daye, Dania; Pena, Miguel A; López, Diego B.; Jaimes, Camilo; Glover, McKinley

doi:10.1007/s00247-021-05111-x

Cited by 14 publications

(6 citation statements)

References 38 publications

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“…When appointments were scheduled over 21 d in advance, families were 4.07 times more likely to miss their dental appointment. Similar to previous research (Lapidos et al 2016; Flores et al 2021), we found a direct proportion between increased wait days resulting in MCOs. This correlation has implications for administrative workflows and operational effectiveness in dental clinics and organizations.…”

Section: Discussionsupporting

confidence: 91%

“…Importantly, we must acknowledge structural drivers of pediatric health inequities, including how racism has historically contributed to poverty, lack of health care access, and patient mistrust (Boyd 2020). Our findings corroborated the racial/ethnic disparities of MCOs in pediatrics seen in prior studies (da Fonseca and Avenetti 2017; Fischer et al 2017; Lynn et al 2018; Como et al 2019; Flores et al 2021). Identifying factors associated with MCOs of at-risk patient populations allows for programs to be designed to mitigate these barriers, such as interventions addressing psychological, structural, and health literacy barriers (Lapidos et al 2016).…”

Section: Discussionsupporting

confidence: 90%

“…Race, education, and income contribute to health inequities (Como et al 2019). Patients from diverse racial/ethnic backgrounds are more likely to miss health care appointments (Iben et al 2000; Shimotsu et al 2016), which contributes to disparities (Fiscella et al 2000; Newacheck et al 2000; Lynn et al 2018; Flores et al 2021) and diminishes the ability to achieve optimal health. They are particularly vulnerable to challenges accessing preventive health care and susceptible to suboptimal oral health outcomes due to lack of health insurance or health care services (Murthy 2016; Como et al 2019; Boyd et al 2020).…”

Section: Introduction/backgroundmentioning

confidence: 99%

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Socioeconomic and Clinical Demography of Dental Missed Care Opportunities

Discepolo

Melvin

Ghazarians

et al. 2022

JDR Clinical & Translational Research

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Introduction: Missed care opportunities (MCOs) contribute to poor health outcomes, and pediatric dental patients are particularly vulnerable; identifying associated patient characteristics will help inform development of targeted interventional programs. Objective: To assess socioeconomic and demographic disparities associated with MCOs among children in an urban pediatric hospital’s dental clinic. MCOs lead to a lack of continuous care and increased emergent needs, so understanding MCOs is required to achieve equitable pediatric dental health. Methods: A retrospective 2-y (2019–2020) cohort of MCOs in children 1 to 17 y old, with scheduled dental visits. MCOs were defined as appointments not attended or canceled and not rescheduled prior to initial scheduled visit. Multivariable mixed-effects logistic regression models with patient-level clustering assessed the associations of demographics, neighborhood-level socioeconomic factors (using social vulnerability index [SVI]), and clinic characteristics with MCOs. Results: Of 30,095 visits, 30.9% were MCOs. Multivariable logistic regression estimated increased likelihood of MCOs in Black/non-Hispanic (odds ratio [OR], 1.20; 95% confidence interval [CI], 1.09–1.32) and Hispanic (OR, 1.18; 95% CI, 1.06–1.31) patients, patients with public insurance (OR, 1.25; 95% CI, 1.15–1.36) or no insurance (OR, 1.46; 95% CI, 1.15–1.85), patients with complex chronic conditions (OR, 1.11; 95% CI, 1.03–1.19), visits scheduled during the COVID-19 pandemic (OR, 9.48; 95% CI, 8.89–10.11), appointments with wait days over 21 d (OR, 4.07; 95% CI, 3.49–4.74), and children from neighborhoods of high social vulnerability (75th percentile SVI) (OR, 1.08; 95% CI, 1.01–1.16). Conclusions: Children with highest dental MCOs were from neighborhoods with high SVI, had public insurance, and were from marginalized populations. MCOs contribute to inequities in overall health; hence, interventions that address barriers related to characteristics associated with pediatric dental MCOs are needed. Knowledge Transfer Statement: Missed care opportunities contribute to poor health outcomes; identifying associated patient characteristics will help inform development of targeted interventional programs. Providing these findings to stakeholders will better impart understanding access barriers and drive research and program development. Dissemination of this information in the form of altering appointment practices will better accommodate specific patient population needs.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 90%

Section: Introduction/backgroundmentioning

confidence: 99%

See 1 more Smart Citation

Socioeconomic and Clinical Demography of Dental Missed Care Opportunities

Discepolo

Melvin

Ghazarians

et al. 2022

JDR Clinical & Translational Research

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“…Over a 12-month period, data from the EMR was retrospectively analyzed for 7,275 patients. Patients of the African American race were more likely to miss appointments, with an odds ratio of 1.9 ( 10 ).…”

Section: Race and Ethnicity In No-showsmentioning

confidence: 99%

Disparities in high risk prenatal care adherence along racial and ethnic lines

Stegman,

Lucarelli-Baldwin,

Ural

2023

Front. Glob. Womens Health

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The term “high-risk pregnancy” describes a pregnancy at increased risk for complications due to various maternal or fetal medical, surgical, and/or anatomic issues. In order to best protect the pregnant patient and the fetus, frequent prenatal visits and monitoring are often recommended. Unfortunately, some patients are unable to attend these appointments for various reasons. Moreover, it has been documented that patients from ethnically and racially diverse backgrounds are more likely to miss medical appointments than are Caucasian patients. For instance, a case-control study retrospectively identified the race/ethnicity of patients who no-showed for mammography visits in 2018. Women who no-showed were more likely to be African American than patients who kept their appointments, with an odds ratio of 2.64 (4). Several other studies from several other primary care and specialty disciplines have shown similar results. However, the current research on high-risk obstetric no-shows has focused primarily on why patients miss their appointments rather than which patients are missing appointments. This is an area of opportunity for further research. Given disparities in health outcomes among underrepresented racial/ethnic groups and the importance of prenatal care, especially in high-risk populations, targeted attempts to increase patient participation in prenatal care may improve maternal and infant morbidity/mortality in these populations.

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“…In their original article "Advanced Imaging of Disease Unrelated to the Coronavirus Disease 2019 (COVID-19) during the Pandemic: Effect of Patient Demographics in a Pediatric Emergency Department," Jarret et al probed the important issue that the disparity of imaging resources limits our ability to provide equitable care for all patients regardless of their backgrounds. Shah et al, in the article titled "Racial and Ethnic Disparities in Pediatric Magnetic Resonance Imaging: Missed Care Opportunities," elegantly built on a study of pediatric imaging missed care opportunities (MCOs) by Dr. Efren Flores and his colleagues published in Pediatric Radiology in 2021 [1]. The article by Dr. Shah et al corroborates that pediatric health care providers across specialties must continue to identify systemic barriers to health care access for diverse children and those from socially vulnerable areas.…”

mentioning

confidence: 99%