Missed Appointments at a Child Development Centre and Barriers to Access Special Needs Services for Children in Klang Valley, Malaysia: A Mixed Methods Study

Abstract

Attending appointments is vital for children with special needs, as such appointments involve long-term interdisciplinary care to ensure continuity of care and improve health and well-being. This study was performed to determine the prevalence of missed clinic appointments and identify the factors among those who have ever missed appointments and barriers of access to children’s special needs services at the Child Development Centre (CDC) at the Universiti Kebangsaan Malaysia Medical Centre (UKMMC). Moreover, suggestions for improvement from the caregivers’ perspectives were explored. This is an explanatory sequential mixed methods study among caregivers of children with developmental disabilities aged up to 17 years old. Of 197 caregivers, 62 (31.5%) had missed clinic appointments. Forgetfulness was the most frequently cited reason. The bi-variable analysis showed significant differences in missed appointment rates by gender of caregivers and duration of follow-up. The final logistic regression model demonstrated that, when combined with the effect of being a male caregiver as an independent variable, follow-up duration of more than 6 years increased 2.67 times the risk of missing an appointment. Caregivers’ perceived barriers were transportation, caregiver, child and healthcare services factors. Policies and strategic plans should be focused on key findings from these factors to improve appointment adherence and accessibility to services for children with special needs.

Exploring the barriers and expectations towards health care services among parents/caretakers of people with intellectual disability in Kuantan, Malaysia: A qualitative study

“…[ 21 ] Thus, it may demand additional flexibility in appointment scheduling. [ 22 ] To enhance appointment attendance and accessibility to services for PWID, policies and strategic plans should be focused on the important findings from these factors.…”

Perceptions toward healthcare and dental care services among parents and caretakers of people with intellectual disability (PWID)—A questionnaire study

“…We constructed the questionnaire based on existing literature on this topic. [ 3 7 , 14 ] The new questionnaire was created because no validated questionnaires from previous studies fit our research objectives. This is mainly because this is the first quantitative study looking into perceptions of healthcare services among parents and caretakers of PWID, particularly in Malaysia.…”